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Inflammatory Pseudotumor of the Liver Masquerading as Hepatocellular Carcinoma After a Hepatitis B Virus Infection: Report of a Case

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Abstract

We report a rare case of hepatic inflammatory pseudotumor (IPT) after a hepatitis B virus (HBV) infection. Early contrast enhancement on computed tomography (CT) with a washout phenomenon at the delayed phase, and depleted Kupffer cell function on superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) suggested hepatocellular carcinoma (HCC). However, the lack of a tumor capsule, absence of liver cirrhosis, and normal serum levels of α-fetoprotein and PIVKA-II (protein induced by vitamin K absence; descarboxyprothrombin) contradicted this diagnosis. We excised the tumor to exclude malignancy, and the histopathological diagnosis was IPT. Recent evidence suggests that this entity has changed from an extremely rare pathology to an established disease. Thus, IPT should be considered in the differential diagnosis of a liver mass with an infectious–inflammatory antecedent. Although surgery is not mandatory, surgical removal is recommended if there is a possibility of malignancy. Further investigations are warranted to elucidate the mechanisms of IPT developing after an HBV infection.

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Authors and Affiliations

  1. Departments of Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan

    Tomotaka Akatsu & Masaki Kitajima

  2. Departments of Diagnostic Radiology, Keio University, School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan

    Akihiro Tanimoto

  3. Departments of Division of Diagnostic Pathology, Keio University, School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan

    Kaori Kameyama

  4. Department of Surgery 1, Iwate Medical University, School of Medicine, Morioka, Japan

    Go Wakabayashi

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  1. Tomotaka Akatsu
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  2. Go Wakabayashi
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  3. Akihiro Tanimoto
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  4. Kaori Kameyama
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  5. Masaki Kitajima
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Akatsu, T., Wakabayashi, G., Tanimoto, A. et al. Inflammatory Pseudotumor of the Liver Masquerading as Hepatocellular Carcinoma After a Hepatitis B Virus Infection: Report of a Case. Surg Today 36, 1028–1031 (2006). https://doi.org/10.1007/s00595-006-3306-6

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  • DOI: https://doi.org/10.1007/s00595-006-3306-6

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