Inflammatory Pseudotumor of the Liver Treated by Hepatic Resection: A Case Report

Inflammatory pseudotumor (IPT) of the liver is rare benign tumor. When the diagnosis of IPT is established with biopsy, simple observation or conservative therapy is preferred because of the possibility of regression. But IPT is unresponsive to the conservative treatment, surgical resection should be considered. We experienced a 63-year-old male, who was suspected hepatocellular carcinoma in abdominal computed tomography (CT) and magnetic resonance image (MRI) scan, presented with 2-month history of intermittent fever and weight loss. Percutaneous ultrasound guided core biopsy confirmed IPT of the liver. Non-steroidal anti-inflammatory drugs and antibiotics were administered for 8 and 4 weeks, respectively, but fever continued. So, extended right hepatectomy was performed for IPT of the liver and then fever subsided. The patient remains well during a follow-up period of 12 months.

Actual Five-year Survival Rate of Hepatocellular Carcinoma after Curative Resection

PURPOSE: After curative resection for hepatocellular carcinoma (HCC), the five-year survival rate ranges between 30~50%; however, this might be different from the actual survival rate. The actual 5-year survival rate and prognostic factors following curative resection for HCC were analyzed. METHODS: A retrospective analysis was performed on 63 HCC patients, who had undergone curative resection, between 1998 and 1999. RESULTS: A total of 63 cases, including 53 men and 10 women, were reviewed. The median age was 49 years old. Pathologic T stage I, II, III and IV were observed in 1, 17, 38 and 7 cases, respectively. The actual 1-, 3- and 5-year survival rates were 85.7, 69.8 and 57.0%, respectively, with a median survival time of 58 months. The actual 1-, 3- and 5-year disease free survival rates were 68.1, 51.9 and 50.2%, respectively, with a median disease free survival time of 46 months. Thirty-one patients had recurrence, mostly within one year (65%), indicating a poor survival rate, with an actual 5-year survival rate of 5%. A satellite nodule, the pT stage, recurrence of tumor, time to recurrence (within one year), and presence of extrahepatic metastasis were found to be prognostic factors influencing the survival rate of HCC patients. However, microvessel invasion caused a difference in the survival rate, but without statistical significance (p=0.08). A satellite nodule, microvessel invasion and the pT stage were found to be factors influencing the disease free survival rate of HCC patients. No statistically related factors, with the exception of the pT stage, were found in a multivariate analysis. CONCLUSION: The actual 5-year survival and disease free survival rates were 57.0 and 50.2%, respectively. The time to recurrence and pT stage were found to be factors influencing the survival rate of patients with a hepatocellular carcinoma. Further advanced studies will have to be carried out for the active treatment of HCC cases with a pT stage III or IV to reduce recurrence.

Inflammatory Pseudotumor of the Liver Treated by Hepatic Resection

An inflammatory pseudotumor of the liver is a rare benign tumor, which is frequently misdiagnosed as malignant. A 63 year-old man presented with a 4-month history of weight loss and a 2-month history of intermittent fever and chills. A computed tomographic (CT) scan and magnetic resonance imaging of the abdomen demonstrated a large tumor in segment 8 of the liver. An ultrasound-guided core biopsy confirmed an inflammatory pseudotumor of the liver. His fever persisted for 3 months, despite the administration of Naproxen and antibiotics. A right trisegmentectomy was carried out, after which the fever subsided. The patient has remaineds well for the last 7 months.