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Hepatic inflammatory pseudotumor: A case series.

Guilherme D Calomeni1, Elaine B Ataíde, Ricardo R Machado

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Inflammatory pseudotumor (IPT) is a rare liver lesion. While antibiotics are a first-line treatment, surgical resection is often required for diagnosis and management, with prognosis varying based on patient factors.

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Area of Science:

  • Hepatology
  • Surgical Pathology
  • Oncology

Background:

  • Inflammatory pseudotumor (IPT) is a rare neoplastic lesion characterized by inflammatory and myofibroblastic cells.
  • These lesions can occur in various organs, with fewer than 300 cases documented globally.
  • Hepatobiliary inflammatory pseudotumor (HIPT) specifically affects the liver, presenting diagnostic challenges.

Purpose of the Study:

  • To review the clinical presentation, diagnostic challenges, and management outcomes of hepatobiliary inflammatory pseudotumor (HIPT).
  • To highlight the differential diagnoses and therapeutic strategies for HIPT.
  • To assess the prognostic factors influencing patient outcomes in HIPT cases.

Main Methods:

  • Retrospective case series analysis of four patients diagnosed with HIPT.
  • Review of clinical data including patient demographics, symptoms, imaging findings (CT scans), and treatment modalities.
  • Histopathological confirmation of HIPT following surgical resection or other interventions.

Main Results:

  • Four cases of HIPT are presented, involving patients with diverse clinical presentations and comorbidities (e.g., cirrhosis).
  • Initial treatments, including antibiotics and embolization, were often ineffective, necessitating surgical intervention.
  • Outcomes varied: two patients experienced successful recovery post-resection, while two cirrhotic patients with complications died.

Conclusions:

  • HIPT is a rare and diagnostically challenging entity with a broad differential diagnosis.
  • Antibiotics represent a first-line therapy, but surgical resection is frequently essential for definitive diagnosis and treatment.
  • While the overall prognosis for HIPT can be favorable, comorbidities significantly impact patient outcomes.