Hepatic inflammatory myofibroblastic tumor: A case report

Abstract

Background: Hepatic inflammatory myofibroblastic tumor (HIMT) is a rare type of hepatic tumor. It is always misdiagnosed and mistreated because it is primarily found with no obvious specific manifestation, and its imaging findings are diverse.

Case summary: Here, we report a case of HIMT that was initially diagnosed as liver malignancy but was confirmed as HIMT by histopathology after hepatectomy. Mostly, HIMTs are infiltrated with plasma cells and stain positively for anaplastic lymphoma kinase on immunohistochemistry as well as for some other kinases.

Conclusion: HIMT can be treated with single nonsteroidal anti-inflammatory drugs and without surgery when it is diagnosed accurately. Because the etiology of HIMT is unknown and the diagnosis is difficult, the pathogenesis and clinical process need to be further studied.

Keywords: Anaplastic lymphoma kinase; Case report; Hepatic inflammatory myofibroblastic tumor; Laparoscopic hepatectomy; Liver neoplasms.

Figure 1

Computed tomography and magnetic resonance imaging revealed a right lower posterior lobe vascular enhancement mass that was suspected to be a malignant tumor. A-C: Arterial phase, venous phase and delayed phase of enhanced computed tomography showed a fast-in and fast-out typical manifestation of hepatocellular carcinoma; D: Magnetic resonance imaging showed many hepatic nodules of cirrhosis; E and F: Enhanced magnetic resonance imaging showed a typical manifestation of a malignant tumor.

Figure 2

Intraoperative and macroscopic view of liver neoplasm. A: Ultrasound localization of the edge of the hepatectomy; B-D: Process of liver hepatectomy (the black circle in B shows the site of tumor); E and F: Gross view of the resected liver specimen.

Figure 3

Staining of the specimen. A and B: Hematoxylin-eosin stain; C: Immunohistochemistry (IHC) stain of CD138; D: IHC stain of anaplastic lymphoma kinase.