Hepatic inflammatory pseudotumor mimicking hepatocellular carcinoma

Abstract

Inflammatory pseudotumor of the liver is a rare tumor. It has variable clinical presentations and image findings. It can mimic benign or malignant hepatic tumors, and may be difficult to diagnose. We present a case in which a hepatic inflammatory pseudotumor was misdiagnosed as hepatocellular carcinoma because the tumor presented a typical enhancing profile and morphology of hepatocellular carcinoma on computed tomography, and the patient had liver cirrhosis. However, a thicker tumor capsule than that of typical hepatocellular carcinoma was noted while reviewing the computed tomography images. A capsule of inflammatory pseudotumor thicker than that of hepatocellular carcinoma has never been reported in the literature before, and could be an important diagnostic clue to differentiate inflammatory pseudotumor from hepatocellular carcinoma.

Hepatic Inflammatory Pseudotumor Protruding from the Liver Surface and Directly Penetrating the Colon

“…In rare cases, multiple hepatic IPTs are reported (4,9). In addition, there are some case reports of hepatic IPT extrahepatic growth patterns mimicking the present patient (19)(20)(21). The present case also had two lesions that directly invaded the colon, mimicking malignant tumors.…”

Contrast‐Enhanced Sonographic Characteristics of Hepatic Inflammatory Pseudotumors

“…On angiography, the lesion appears hypervascular, consistent with a malignant tumor 11 . Many atypical forms have been reported, such as multiseptated cystic forms, 12 thick tumor capsule lesions, 10 and multiple masses 14…”

Inflammatory Pseudotumor of the Liver in Patient with Type 2 Diabetes

“…Precise diagnosis of lesions is difficult because they are rare conditions and clinical symptoms and laboratory findings are nonspecific. Furthermore, both clinical presentation and radiological images may be suggestive for malignancy [4,[11][12][13]15,16,22,27,30,31 ]. In the liver IPT has to be distinguished from hepatocellular carcinoma [15,16,27], intrahepatic cholangiocarcinoma [11,13], metastases [12,30] and inflammatory conditions mostly abscesses [17,22].…”

“…Majority cases are located in the right lobe. Radiological findings of the IPT are nonspecific but benign histopathological features constitute the hallmark of this lesion [12][13][14]16,17].…”