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Patel A, Chen A, Lalos AT. Inflammatory pseudotumors in the liver associated with influenza: A case report. World J Hepatol 2023; 15:1164-1169. [PMID: 37970616 PMCID: PMC10642433 DOI: 10.4254/wjh.v15.i10.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/18/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Inflammatory pseudotumor (IPT) is a rare and benign lesion that mimics malignancy and can develop in any part of the body. The pathophysiology and etiology of these quasineoplastic lesions remain unclear. CASE SUMMARY We report a case of a 65-year-old male who presented with fevers, night sweats, and unintentional weight loss following an influenza infection and was found to have multiple hepatic IPT's following an extensive work up. CONCLUSION Our case highlights the importance of considering hepatic IPT's in the differential in a patient who presents with symptoms and imaging findings mimicking malignancy shortly following a viral infection.
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Affiliation(s)
- Ankoor Patel
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, United States.
| | - Alexander Chen
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, United States
| | - Alexander T Lalos
- Department of Gastroenterology and Hepatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, United States
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Li YY, Zang JF, Zhang C. Laparoscopic treatment of inflammatory myofibroblastic tumor in liver: A case report. World J Clin Cases 2022; 10:11853-11860. [PMID: 36405255 PMCID: PMC9669864 DOI: 10.12998/wjcc.v10.i32.11853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor in the liver (IMTL) is a rare borderline mesenchymal tumor. Neither clinical symptoms nor laboratory tests have absolute specificity for the diagnosis of IMTL, and imaging also lacks obvious specificity. Although there are sporadic reports of recurrence after surgical treatment, surgical resection is the mainstay of treatment.
CASE SUMMARY A 29-year-old man complained of general weakness, slight discomfort in the upper abdomen, with a history of upper respiratory tract infection for 1 wk before admission. Plain and enhanced upper abdominal magnetic resonance imaging showed a mass in liver segments II and III (48 mm × 53 mm). He was treated by laparoscopic left lateral segmentectomy. Postoperative pathological examination with hematoxylin and eosin staining suggested that the mass in liver segments II and III was IMTL. During 21 mo postoperative follow-up, no obvious residual or recurrent lesions were observed.
CONCLUSION There is a risk of malignant degeneration in IMTL. The principal choice of treatment is laparoscopic left lateral segmentectomy.
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Affiliation(s)
- Yang-Yang Li
- Department of Hepatobiliary Surgery, Taizhou People’s Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China
| | - Jin-Feng Zang
- Department of Hepatobiliary Surgery, Taizhou People’s Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China
| | - Chi Zhang
- Department of Hepatobiliary Surgery, Taizhou People’s Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China
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Ishii-Kitano N, Enomoto H, Nishimura T, Aizawa N, Shibata Y, Higashiura A, Takashima T, Ikeda N, Yuri Y, Fujiwara A, Yoshihara K, Yoshioka R, Kawata S, Ota S, Nakano R, Shiomi H, Hirota S, Kumabe T, Nakashima O, Iijima H. Multiple Inflammatory Pseudotumors of the Liver Demonstrating Spontaneous Regression: A Case Report. Life (Basel) 2022; 12:life12010124. [PMID: 35054517 PMCID: PMC8779591 DOI: 10.3390/life12010124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/24/2022] Open
Abstract
Inflammatory pseudotumor (IPT) of the liver is a rare benign disease. IPTs generally develop as solitary nodules, and cases with multiple lesions are uncommon. We herein report a case of multiple IPTs of the liver that spontaneously regressed. A 70-year-old woman with a 10-year history of primary biliary cholangitis and rheumatoid arthritis visited our hospital to receive a periodic medical examination. Abdominal ultrasonography revealed multiple hypoechoic lesions, with a maximum size of 33 mm, in the liver. Contrast-enhanced computed tomography revealed low-attenuation areas in the liver with mild peripheral enhancement at the arterial and portal phases. We first suspected metastatic liver tumors, but fluorodeoxyglucose positron emission tomography, magnetic resonance imaging and contrast-enhanced ultrasonography suggested the tumors to be inconsistent with malignant nodules. A percutaneous biopsy showed shedding of liver cells and abundant fibrosis with infiltration of inflammatory cells. Given these findings, we diagnosed the multiple tumors as IPTs. After careful observation for two months, the tumors almost vanished spontaneously. Physicians should avoid a hasty diagnosis of multiple tumors based solely on a few clinical findings, and a careful assessment with various imaging modalities should be conducted.
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Affiliation(s)
- Noriko Ishii-Kitano
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Hirayuki Enomoto
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
- Correspondence:
| | - Takashi Nishimura
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
- Ultrasound Imaging Center, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan; (Y.S.); (A.H.)
| | - Nobuhiro Aizawa
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Yoko Shibata
- Ultrasound Imaging Center, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan; (Y.S.); (A.H.)
| | - Akiko Higashiura
- Ultrasound Imaging Center, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan; (Y.S.); (A.H.)
| | - Tomoyuki Takashima
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Naoto Ikeda
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Yukihisa Yuri
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Aoi Fujiwara
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Kohei Yoshihara
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Ryota Yoshioka
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Shoki Kawata
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Shogo Ota
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Ryota Nakano
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Hideyuki Shiomi
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan;
| | | | - Osamu Nakashima
- Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume 830-0011, Fukuoka, Japan;
| | - Hiroko Iijima
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya 663-8501, Hyogo, Japan; (N.I.-K.); (T.N.); (N.A.); (T.T.); (N.I.); (Y.Y.); (A.F.); (K.Y.); (R.Y.); (S.K.); (S.O.); (R.N.); (H.S.); (H.I.)
- Ultrasound Imaging Center, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan; (Y.S.); (A.H.)
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