Inflammatory pseudotumors of the liver: Experience of a specialist surgical unit

Abstract

Inflammatory liver pseudotumors are a difficult entity to identify. Resection should be considered because it may be impossible to rule out malignancy by other means.

A Case of Inflammatory Pseudotumor of the Liver Mimicking Hepatocellular Carcinoma on EOB-MRI and PET

“…Due to the lack of characteristic clinical and radiological features for diagnosis, IPT may be mistaken as malignant tumor such as cholangiocarcinoma, or liver abscess [1–3]. In particular, IPT may be a vascular-rich tumor demonstrating radiological findings similar to those of hepatocellular carcinoma (HCC) [4]. In a patient with risk factors for HCC, such as chronic viral hepatitis and liver cirrhosis, the presence of IPT may be misdiagnosed as HCC, and a correct diagnosis is established only by biopsy or surgery [5, 6].…”

“…In a patient with risk factors for HCC, such as chronic viral hepatitis and liver cirrhosis, the presence of IPT may be misdiagnosed as HCC, and a correct diagnosis is established only by biopsy or surgery [5, 6]. This lesion is usually diagnosed clinically or by conventional imaging methods [3, 4]. Clinical diagnosis is difficult in patients with nonspecific symptoms and no serological evidence of inflammation.…”

Cholangiocarcinoma – new concepts and classifications

“…18 Finally, because of the difficulty obtaining a tissue diagnosis, some stenosing lesions with malignant characteristics on imaging later prove to be inflammatory e so-called Klatskin-mimicking tumours 19 ; the term 'inflammatory pseudotumour' has also been used in this context when there is an associated mass lesion. 20 Histological assessment after resection may allow a more precise diagnosis to be made e examples of lesions that can mimic hilar cholangiocarcinoma include IgG4 disease 21 and rarer disorders such as follicular cholangitis, 22 or eosinophilic cholangitis. 23 Unilateral lobar atrophy usually occurs in the setting of combined biliary and portal vein occlusion; a significant correlation exists with ipsilateral portal vein obstruction which may be benign or malignant.…”

Inflammatorische Pseudotumoren der Leber bei Morbus Crohn: ein möglicher Pitfall bei der Echokontrast-Sonografie

“…Andere Autoren diskutieren eine überschießende lokale Immunreaktion z. B. nach Trauma als Ursache eines IPT [8]. Teilweise ergaben sich Hinweise auf eine Assoziation mit akut oder chronisch entzündlichen [9 -11] sowie mit sklerosierenden [12] und anderen autoimmunen Erkrankungen [13].…”