Inflammatory Pseudotumor of the Liver: Clinical Case

The authors present the case of an 81-year-old man with hypertension and alcohol consumption (60–80 g/ day) who was admitted to the Emergency Department with abdominal pain in the upper right quadrant, with 1 month of evolution, diarrhea (5–6 liquid stools per day), and slimming of 10 kg in the past 2 months. He had no fever or stigmas of alcoholic liver disease. Analytically, he had no increase in inflammatory markers, but because of these complaints, an abdominal computed tomography was performed, which showed a bulky mass. The mass occupied almost the whole right lobe of the liver, measured 14.5 cm of greater axis, and had well-defined contours and signs of intralesional necrosis at the central level. The patient was referred to the Ambulatory Liver Unit. In the first evaluation, a hard mass in the upper right quadrant was detected, with well-defined limits and slightly painful to deep palpation. In the etiological study, we highlight: hemoglobin 9.27 g/dL (normal: 13–18), mean corpuscular volume 109 fL (normal: 87–103), mean corpuscular hemoglobin (HGM) 35.3 pg (normal: 27–33), leukocytes 5,000/μL (normal: 4,000–11,000), platelets 377,000/μL (normal: 150,000–400,000), aspartate aminotransferase 33 U/L (normal: < 40), alanine aminotransferase 23 U/L (normal: < 41), gamma-glutamyltransferase 96 U/L (normal: 10–49), total bilirubin 0.6 mg/dL (normal: < 1.2), albumin 3.6 g/dL (normal: 3.4– 4.8), alkaline phosphatase 99 U/L (normal: 40–130), Creactive protein 0.6 mg/dL (normal: < 0.5), normal coagulation, renal function, and ionogram, negative viral serology (hepatitis B virus, hepatitis C virus, and human immunodeficiency virus), tumor markers: alpha-fetoprotein 2.2 IU/mL (normal: 1–8), carcinoembryonic antigen 2.3 ng/mL (normal: < 0.5), and CA19.9 77 U/mL (normal: 0–37). In order to better characterize the nodule, abdominal magnetic resonance imaging was performed, which described a well-circumscribed contour lesion, showing a halo with a solid internal structure with