Successful treatment with laparoscopic extended posterior sectionectomy for inflammatory pseudotumor in the liver with para-aortic lymphadenitis

Asian J Endosc Surg. 2023 Jul;16(3):621-626. doi: 10.1111/ases.13202. Epub 2023 Jun 6.

Abstract

Inflammatory pseudotumor (IPT) is a rare disease that requires a differential diagnosis from malignancies. We describe a case of hepatic IPT with para-aortic lymphadenopathy, treated with a stepwise strategy of laparoscopic surgery. A 61-year-old woman was referred with a liver lesion. Computed tomography revealed a 13 cm well-defined lesion in segments VII-VI. The patient also had bead-like enlarged lymph nodes from the perihilar to the para-aortic regions. Although percutaneous lymph node biopsy showed no evidence of malignancy, 18 F-fluorodeoxyglucose positron emission tomography revealed accumulation in the lesion and lymph nodes. Lymph nodes were harvested laparoscopically for intraoperative pathological examination. With no evidence of malignancy, laparoscopic liver resection was continuously performed as a diagnostic treatment. The patient was given a pathological diagnosis of IPT and was discharged on the 16th day and is well 2 years after surgery. The minimally invasive laparoscopic approach to diagnostic treatment could be useful with secure advantages.

Keywords: inflammatory pseudotumor; laparoscopic liver resection; posterior sectionectomy.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Granuloma, Plasma Cell* / diagnostic imaging
  • Granuloma, Plasma Cell* / pathology
  • Granuloma, Plasma Cell* / surgery
  • Humans
  • Laparoscopy
  • Liver*
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymphadenitis* / pathology
  • Lymphadenitis* / surgery
  • Middle Aged