Abstract
A 70-year-old man with a history of HBV infection and slight liver dysfunction was admitted for further examination of a 3.8 cm tumor in segment 5: ultrasound (US) revealed a hypo-iso-hypo pattern and computed tomography (CT) revealed a low-iso-low density pattern (double-target-sign).
While CE US revealed slight hypovascularity, early washout in the portal phase, and defect in the Kupffer phase, contrast-enhanced (CE) CT and ethoxybenzyl diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging (EOB MRI) revealed slight hypervascularity and slight hypointensity at the hepatobiliary phase. Echo planar imaging of MRI revealed remarkable hypointensity.
The aforementioned imaging modalities raised suspicions of inflammatory pseudotumor (IPT), atypical hepatocellular carcinoma, cholangiocellular carcinoma, cholangiolocellular carcinoma, and metastatic liver cancer.
US-guided biopsy, however, showed hepatic IPT, and histopathological analysis disclosed the proliferation of fibroblasts, lymphocytes, plasma cells, and macrophages with hemosiderin on a background of collagen fibers.
Without receiving any kind of treatment, the tumor had shrunk from 3.8 to 2.6 cm three weeks after the diagnosis.
