Hepatic pseudotumor: A diagnostic challenge

Abstract

Hepatic pseudotumors are rare lesions of unknown origin, characterized by the proliferation of fibrous connective tissue and inflammatory cell infiltrates. They mimic malignant lesions clinically, and radiologically, given their non-specific clinical and imaging features. The pathophysiology of hepatic pseudotumor is incompletely understood and there are no standardized criteria for diagnosis. Pseudotumors have been reported to develop in various organs in the body with the lung and liver being the most common site. Hepatic pseudotumors develop in patients with underlying triggers of liver inflammation and injury, including infections, autoimmune liver diseases, bile duct injury, or surgery. Hepatic pseudotumors respond well to conservative treatment with antibiotics, and steroids and some may regress spontaneously, thus avoiding unnecessary resection. This condition is rewarding to treat. It is important to recognize pseudotumor as a distinct clinical entity and include it in the differential of liver masses with atypical imaging features.

Keywords: Hepatic pseudotumor; Infection; Stroglyloides; Hepatic resection

Core Tip: Hepatic pseudotumors may mimic malignant lesions clinically and radiologically and often result in unnecessary invasive procedures. Both clinicians and pathologists should consider this differential in patients with hepatic mass lesions, especially if the patient has a clinical history of infection or injury of the biliary tree and/or hepatic parenchyma.