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肝炎性假瘤酷似恶性肿瘤,罕见发生腹腔内出血。

Hepatic Inflammatory Pseudotumor Mimicking Malignant Tumor With Rare Onset of Intra-abdominal Hemorrhage.

机构信息

Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan.

Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan;

出版信息

Anticancer Res. 2021 May;41(5):2727-2732. doi: 10.21873/anticanres.15054.

Abstract

BACKGROUND

Hepatic inflammatory pseudotumor (HIPT) is an uncommon benign tumor-like mass that mimics malignant tumors.

CASE REPORT

A 73-year-old man was admitted with severe epigastric pain and high fever. He had received choledocojejunostomy. Enhanced computed tomography showed a 76 mm, heterogeneous, gradual enhanced low-density mass in the caudate lobe and hyperdense fluid was detected around the mass. Based on the diagnosis of hemorrhage from a hypervascular malignant liver tumor, chemoembolization was conducted. Antibiotics (Meropenem) were administered for 2 weeks, and methylprednisolone (125 mg) was administered twice as a premedication for chemoembolization. After the 2nd chemoembolization, rapid tumor shrinkage was observed and the inflammatory changes gradually disappeared. The tumor was finally diagnosed as fibrohistiocytic type HIPT with an ultrasound-guided percutaneous tumor biopsy. The diameter of the liver tumor decreased to 15 mm and intra-abdominal hemorrhage disappeared in 3 months.

CONCLUSION

Development of HIPT can be associated with intra-abdominal hemorrhage.

摘要

背景

肝炎性假瘤(HIPT)是一种少见的良性肿瘤样肿块,类似于恶性肿瘤。

病例报告

一名 73 岁男性因严重上腹痛和高热入院。他曾接受过胆肠吻合术。增强 CT 显示尾状叶有一个 76mm、不均匀、逐渐增强的低密度肿块,肿块周围检测到高密度液体。基于肝内富血管性恶性肿瘤出血的诊断,进行了化疗栓塞术。给予抗生素(美罗培南)治疗 2 周,并在化疗栓塞术前行甲泼尼龙(125mg)两次预治疗。第 2 次化疗栓塞术后,观察到肿瘤迅速缩小,炎症改变逐渐消失。最终通过超声引导下经皮肿瘤活检诊断为纤维组织细胞型 HIPT。3 个月后,肝肿瘤直径缩小至 15mm,腹腔内出血消失。

结论

HIPT 的发生可伴有腹腔内出血。

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