Inflammatory pseudotumor of the liver: A bare benign tumor mimicking a malignancy

We describe a 9-month-old boy in whom a hepatic tumor called angioma was di agnosed on ultrasonography, performed for abdominal pain. He was asymptomat ic until 9 months later, when he presented with weight loss, jaundice, and a hard tumor in the left liver lobe. Radiological examination showed a calc ified and heterogeneous tumor, amputation of the left portal vein, and dila tation of bile ducts, strongly suggesting malignancy, However, liver biopsy showed the typical findings of inflammatory pseudotumor, which are myofibr oblastic cells and perivascular plasmocytes in a dense collagenous stroma, The tumor was surgically removed without local recurrence with a 2-year fol low-up. Inflammatory pseudotumor in childhood is more common in the lung an d elsewhere is often mistaken for a slowly growing cancer. This case points out the difficulties in the radiological evaluation of liver tumors in chi ldhood and the importance of the histological differentiation of this lesio n from malignancy before laparotomy for adequate indication of the treatmen t, which includes no medical treatment and surgery as conservative as possi ble. Copyright (C) 1999 by the American Association for the Study of Liver Diseases.