Berloco P, Caricato M, Ripetti V, Cellamare C, Altomare V, Alloni R, Arullani A
Libero Istituto, Roma.
Ann Ital Chir. 1998 May-Jun;69(3):371-7.
Inflammatory pseudotumor of the liver is a rare entity of unknown etiology; fewer than 80 cases have been reported in the world literature. Its appearance on the computerized tomography, ultrasound and magnetic resonance have been previously described as nonspecific, and clinical presentation is not helpful in the diagnosis. This is why the diagnosis usually is made after laparotomy and often after the excision of the tumor. Several recent reports show that drug therapy is effective and lead to tumor regression, while other authors believe that an aggressive approach should be taken, due to the potential adverse impact of its vascular invasive and biliary obstructive nature. Herein we describe a case of this clinical entity, which occurred in a 52 years old patient, where the operative examination showed bilobar involvement, treated with right hepatectomy and contra-lateral tumor excision in the clinical suspect of hepatocellular carcinoma. The detailed clinical, radiological and pathological picture is described. At 6 months follow-up the patient conditions are excellent. On the basis of the available literature, we discuss the clinical features and the therapeutical problems of such rare clinical entity, and propose a selected use of liver biopsy when the clinical suspicion of pseudotumor can be considered, in order to achieve a preoperative diagnosis and therefore to avoid surgery.
肝脏炎性假瘤是一种病因不明的罕见疾病；世界文献报道的病例少于80例。其在计算机断层扫描、超声和磁共振成像上的表现先前已被描述为非特异性的，临床表现对诊断也无帮助。这就是为什么通常在剖腹手术后，且常常是在肿瘤切除后才做出诊断。最近的几份报告表明药物治疗是有效的，并能使肿瘤消退，而其他作者则认为应采取积极的治疗方法，因为其具有血管侵犯和胆管阻塞的性质，可能会产生不良影响。在此我们描述一例发生在一名52岁患者身上的这种临床疾病，手术检查显示双侧受累，在临床怀疑为肝细胞癌的情况下，行右肝切除术及对侧肿瘤切除术进行治疗。描述了详细的临床、放射学和病理学情况。在6个月的随访中，患者情况良好。基于现有文献，我们讨论了这种罕见临床疾病的临床特征和治疗问题，并建议在可考虑临床怀疑为假瘤时选择性地进行肝活检，以实现术前诊断，从而避免手术。
