A case of hepatic inflammatory pseudotumor resected as intrahepatic cholangiocarcinoma

• Published in: Tando Vol. 34; no. 4; pp. 672 - 679
• Main Authors: Miyauchi, Toshiya, Takahashi, Masato, Tsuda, Hidehiko, Sasaki, Toshiki, Kanomata, Hiroyuki
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 31.10.2020; 一般社団法人 日本胆道学会
• Subjects: inflammatory pseudotumor; intrahepatic cholangiocarcinoma; 炎症性偽腫瘍; 肝内胆管癌
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando.34.672

A 78-year-old woman was confirmed the dilatation of the intrahepatic bile duct by abdominal ultrasonography and was referred to our hospital. Contrast-enhanced CT showed a 2cm-sized tumor in the vicinity of the left hepatic duct. ERCP showed a stenosis in the left hepatic duct and the anterior segment, and was negative for cancer by bile cytology and bile duct brushing cytology. Biopsy was performed a cholangioscope (spyglass®), but the cancer was negative. Although no cancer was diagnosed histopathologically, it was difficult to rule out the cancer due to sampling errors and the possibility of mass-forming intrahepatic cholangiocarcinoma, so we performed left trisectionectomy, caudate lobectomy, and extrahepatic bile duct resection. After surgery, she had bile leakage but was relieved by drainage and discharged on the 42nd hospital day. Pathological examination revealed that the mass has only fibrosis and inflammatory cells without neoplastic tissues. She was diagnosed with a hepatic inflammatory pseudotumor.