Abstract
We report a case of inflammatory pseudotumor (IPT) of the liver with marked elevation of PIVKA-II level in the liver with alcoholic liver cirrhosis. The patient was a 74-year-old man who had a heavy drinking history of 4,000ml of beer per day. The patient was referred to another hospital due to liver dysfunction detected at a medical checkup. Abdominal ultrasonography revealed a mass, 60 mm in diameter, in the right lobe of the liver. Then he was referred to our hospital. When he was first seen, the body temperature was 37.0°C, and a slight degree of increase in inflammatory reaction was noted in a blood analysis. The tumor marker PIVKA-II level elevated up to 554 mAU/ml. HBs antigen and HCV antibody were negative. Abdominal computed tomography late and magnetic resonance imaging findings provided a low intensity lesion on T1 weighted, and a high intensity on T2-weighted images suspected diagnosis of hepatocellular carcinoma. A subsegmentectomy (S7) was performed and the histopathological study revealed a growth of myofibroblasts with infiltration of lymphocytes and plasmacytes. IPT of the liver was thus diagnosed. After the operation, the PIVKA-II level decreased to 14 mAU/ml. Vitamin K deficiency due to malnutrition can occur in patients with alcoholic liver cirrhosis, so that we should carefully evaluate the increase of serum PIVKA-II levels in alcoholic such patients.
