Ann Hepatobiliary Pancreat Surg.  2021 Feb;25(1):34-38. 10.14701/ahbps.2021.25.1.34.

Clinicopathological features and post-resection outcomes of inflammatory pseudotumor of the liver

Affiliations
  • 1Department of Surgery, Anyang SAM Hospital, Anyang, Korea
  • 2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 3Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Backgrounds/Aims
Hepatic inflammatory pseudotumor (HIPT) is a rare disease characterized by chronic infiltration of inflammatory cells and area of fibrosis. The objective of this retrospective observational study was to investigate clinicopathological features and outcomes of patients who underwent hepatic resection (HR) for HIPT.
Methods
From 2009 to 2018, seven patients with HIPT underwent HR, accounting for 0.06% of 11,979 adults who underwent HR at our center.
Results
These seven patients included five men and two women. Their mean age was 62.3±11.6 years. In four patients with hepatitis B virus (HBV)-associated liver cirrhosis or chronic hepatitis, liver masses were suspected of hepatocellular carcinoma (HCC) or combined HCC-cholangiocarcinoma based on imaging studies. In three patients without HBV infection, two patients were suspected of HCC, for whom liver biopsy was not performed. One patient was suspected of liver abscess or HIPT, for whom percutaneous liver biopsy was performed and the mass was diagnosed with HIPT. However, this patient underwent HR owing to abdominal pain. No patient presented with abnormally elevated levels of alpha-fetoprotein, protein induced by vitamin K absence or antagonist-II, or CA19-9. During a mean follow-up period of 76.4±34.8 months, no patient experienced recurrence of HIPT.
Conclusions
HIPT, a rare form of liver disease, is often misdiagnosed as malignant liver tumor. Active histological diagnosis is warranted for patients with suspected HIPT to avoid unnecessary operation. HR can be indicated in case of diagnostic ambiguity of HIPT or under a clinical diagnosis of malignant liver tumor.

Keyword

Abscess; Inflammation; Liver mass; Benign disease; Hepatocellular carcinoma

Figure

  • Fig. 1 Preoperative computed tomography findings and gross photographs of surgical specimens obtained after initial hepatectomy. Number denotes Case number.


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