Inflammatory pseudotumour of the liver: antecedent causes and clinical experience

We present a case in which inflammatory pseudotumour of the liver which appears to complicate Caroli's disease. We have reviewed the literature in hepatic inflammatory pseudotumour with particular emphasis on underlying causes. We were able to find 45 reported cases, with adequate clinical data in 42; in these only 7 showed a probable antecedent cause. There were gallstones in another 5, giving a prevalence not significantly different to that within the general population. Hepatic inflammatory pseudotumour typically presents with a history of fever, anorexia, loss of weight, hepatic pain, jaundice and a detectable liver mass (or masses). The diagnosis of inflammatory pseudotumour should be particularly considered when there is a history of previous inflammatory hepato-biliary disease. Preoperative or intra-operative diagnosis might then avoid major hepatic surgery.