Laparoscopic Hepatectomy for Hepatic Inflammatory Myofibroblastic Tumor: A Case Report

Inflammatory myofibroblastic tumors (IMTs) are neoplasms composed of spindle-shaped myofibroblasts along with inflammatory infiltrate, and possess malignant potential. Primary hepatic IMTs (HIMTs) are relatively uncommon and difficult to distinguish from liver malignancies such as intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma due to the lack of characteristic radiological findings.

We present the case of a 76-year-old man with a medical history of renal cell carcinoma and gastric cancer. During routine follow-up, a CT revealed an irregular tumor measuring 30 mm in liver segment 5 (S5), which enlarged to 35 mm over a 6-month observation period. MRI demonstrated high signal intensity on diffusion-weighted imaging, while PET showed high standard uptake volume (11.2), suggestive of ICC or HIMT. A laparoscopic hepatic S5 sub-segmentectomy was performed. Pathological examination revealed spindle-cell proliferation with marked lymphoplasmacytic infiltration. The immunohistochemistry results were positive for anaplastic lymphoma kinase and smooth muscle actin. The patient was discharged on POD 10 and has remained recurrence-free 2 years following surgery.

HIMT is rare and poses significant diagnostic challenges that often mimic other liver malignancies. This case report highlights the efficacy and safety of laparoscopic hepatectomy as both a diagnostic and therapeutic strategies.