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Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica.

Gowthami Kanagalingam1, Khadija N Dulymamode2, Abtin Jafroodifar3

  • 1Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

Journal of Investigative Medicine High Impact Case Reports
|January 18, 2022
PubMed
Summary

Inflammatory pseudotumors of the liver are rare, non-neoplastic masses that can mimic cancer. This case highlights a liver inflammatory pseudotumor in a patient with polymyalgia rheumatica, showing potential steroid-induced regression.

Keywords:
autoimmune diseaseliver masspolymyalgia rheumatica

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Area of Science:

  • Hepatology
  • Oncology
  • Rheumatology

Background:

  • Inflammatory pseudotumors (IP) are rare, benign liver lesions.
  • IPs present nonspecifically, often mimicking malignant liver tumors.
  • Accurate diagnosis can necessitate invasive procedures due to overlapping features.

Observation:

  • A 61-year-old female with comorbidities presented with abdominal pain.
  • Imaging revealed a liver lesion; biopsy confirmed an IgG4-negative inflammatory pseudotumor.
  • The lesion initially grew rapidly, then significantly decreased in size after increased steroid dosage for polymyalgia rheumatica.

Findings:

  • This is the first reported case of a liver IP in a patient with polymyalgia rheumatica.
  • The case suggests a potential role for corticosteroids in managing liver IPs.
  • The observed regression highlights the dynamic nature of these lesions.

Implications:

  • Increases awareness of liver IP as a differential diagnosis in patients with autoimmune conditions.
  • Suggests considering IP in the differential for liver lesions, especially in patients with autoimmune disorders.
  • Highlights the importance of considering treatment response in the diagnostic workup of liver lesions.