title: Inflammatory pseudotumor of the liver occurring during the course of hepatitis C virus-related hepatocellular carcinoma treatment: A case report.
abstract: BACKGROUND
  Inflammatory pseudotumor (IPT) of the liver is a rare and benign disease that has a good prognosis. It is often difficult to distinguish IPT from hepatic malignancies, such as hepatocellular carcinoma (HCC), because specific clinical symptoms are absent and the diseases' radiological findings can be similar. IPT is particularly difficult to distinguish from HCC in livers with hepatitis C virus (HCV)-related cirrhosis. We report a case of IPT of the liver that mimicked HCV-related HCC recurrence.
  
  
  METHODS
  A 78-year-old asymptomatic Japanese man who had undergone hepatectomy for HCV-related HCCs (moderately differentiated type) in segments 7 and 5 four and a half years previously was referred to our hospital for treatment of a 30-mm enhanced tumor in segment 5 (a typical HCC pattern). The tumor was identified via abdominal dynamic computed tomography (CT) and CT with hepatic arteriography and arterial portography. Thereafter, liver segmentectomy 5 was performed, and the histopathological diagnosis was a 10-mm IPT of the liver. After 1.5 years, magnetic resonance imaging revealed two new enhanced lesions in segment 8, which showed the typical pattern of HCC. Because these lesions grew in size for 3 months, liver segmentectomy 8 was performed for HCC recurrence. Histopathological examination showed that both lesions were HCCs.
  
  
  CONCLUSIONS
  HCV-related HCC has a high rate of multicentric recurrence. Our experience suggests that, when a hepatic lesion is suspected to be HCC, surgical resection should be considered for curative treatment and to rule out malignancy, even if the lesion may be an IPT.
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: naruhiko.honmyo@gmail.com.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Honmyo
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: tsukoba@hiroshima-u.ac.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: htashiro@hiroshima-u.ac.jp.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: ishiyama@hiroshima-u.ac.jp.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishiyama
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: ideksyh@yahoo.co.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ide
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: hiboo@nifty.com.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tahara
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: masa-ohira@nifty.com.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: df26@smn.enjoy.ne.jp.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kuroda
authors.affiliation: Department of Anatomical Pathology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: arihiro@hiroshima-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Arihiro
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: hohdan@hiroshima-u.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
keywords: Hepatitis C virus-related hepatocellular carcinoma; Inflammatory pseudotumor; Surgical resection
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