A case of benign inflammatory liver tumor mimicking intrahepatic cholangiocarcinoma

Abstract

A 62-year-old woman was admitted to our hospital because of appetite loss and right upper quadrant pain. Laboratory test showed slight elevations of ALP, γ-GTP, and LAP, however, other liver function tests including serum bilirubin level were within normal ranges. CT scan and MRI imaging demonstrated an irregular infiltrating tumor located mainly in the S4 segment of the liver. The celiac arteriogram revealed encasements of the middle and the right hepatic arteries along with multiple tumor stains indicating cholangiocellular carcinoma with intrahepatic metastases. Although severe fibrous adhesions were noted around the gallbladder and the hepatic tumor, gallstone was absent. US-guided intraoperative biopsy were repeated three times, but no malignant findings were observed. Therefore, wedge biopsy of the hepatic tumor was subsequently performed for further investigation. Histology of the incised specimen confirmed an inflammatory tumor without any malignant findings which consisted of dense fibrous tissue surrounding dilated biliary ductal structures. To our best knowledge, such an inflammatory liver tumor, which we report here, has not been described previously in the literature.