A Case Report of Inflammatory Pseudotumor of the Liver with Occlusion of Right Portal Vein

Takuzo Fujiwara, Shinya Gomi, Nobutaka Murashima, Takamasa Matsumoto, Yoshikazu Akura and Keisuke Hamazaki*

Department of Surgery, Kurashiki Medical Center
Department of Surgery, Digestive Tract Diseases Center, Tsuyama Daiichi Hospital*

A 65-year-old man admitted for a hemorrhagic gastric ulcer but no fever and laboratory data showing normal liver function except for slightly elevated ALP and γ-GTP and negative serology for hepatitis B and C was found on US examination to have a 5 cm diameter tumor of the hepatic right lobe near the hepatic hilum. In contrast-CT, only the tumor margin was enhanced. Portography via the superior mesenteric artery showed the right branch of the portal vein to be completely occluded. Percutaneous needle biopsy under ultrasonic guidance showed the presence of inflammatory but not malignant cells. The tumor, diagnosed as inflammatory hepatic pseudotumor, necessitated right hepatectomy. Pathological findings for the resected specimen were compatible with those of the preoperative diagnosis. He has been followed up for 5 years without sign of recurrence. Inflammatory hepatic pseudotumor is relatively rare and its etiology inconclusive. Surgical treatment should be selected for the cases with the tumor near the hepatic hilum to prevent the occurrence of complications including portal vein or obstructive jaundice.

Key words
inflammatory hepatic pseudotumor, portal vein, hepatectomy

Reprint requests
Takuzo Fujiwara Department of Surgery, Kurashiki Medical Center
250 Bakuro-cho, Kurashiki, 710-8522 JAPAN

Accepted
October 25, 2006

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