Inflammatory pseudotumor of liver secondary to migrated fishbone - a rare cause with an unusual presentation.
A 35-year-old woman presented with a history of vague epigastric pain which lasted for one day. She had no other gastrointestinal symptoms and had an unremarkable past history and physical examination. An ultrasound scan abdomen showed a 3×3.5 cm mass in the left lobe of liver. A CT scan showed an abnormal hypodense lesion with mild enhancement in the arterial phase, with a central calcification. Complete blood count, liver function test and alpha-fetoprotein were normal. A left lateral segmentectomy was performed after adequate pre-operative assessment. The specimen contained a 3 cm long fishbone. The post-operative period was uneventful. Histopathological examination revealed chronic non-specific inflammation with fibrosis. Inflammatory pseudotumor of liver is a rare benign tumor with uncertain etiopathogenesis. Suggested etiologies include a septic or a viral origin and it can occur after migration of sharp objects, including migrated fishbone. Inflammatory pseudotumor of liver can be a diagnostic challenge and may end up in major resection.
Department of Surgical Gastroenterology, Madras Medical College, Chennai, Tamilnadu, India.
Ulagendra Perumal
UP
Srinivasan
Department of Surgical Gastroenterology, Madras Medical College, Chennai, Tamilnadu, India.
Appasamy Benet
AB
Duraisamy
Department of Surgical Gastroenterology, Madras Medical College, Chennai, Tamilnadu, India.
Sethu
S
Ilango
Department of Surgical Gastroenterology, Madras Medical College, Chennai, Tamilnadu, India.
Arunachalam
A
Rathinasamy
Department of Surgical Gastroenterology, Madras Medical College, Chennai, Tamilnadu, India.
Servarayan Murugesan
SM
Chandramohan
Foreign body; fish bone; inflammatory pseudotumor