Inflammatory pseudo-tumor of the liver: is pre-operative diagnosis possible?

zObjectives - To specify the circumstances of detection and the clinical, biological, radiological and pathological features of inflammatory pseudo-tumors, in order to improve preoperative diagnosis. Methods - Diagnosis of inflammatory pseudo-tumors of the liver was performed on surgical specimens in 8 patients from January 1987 to January 2001. We retrospectively analyzed the clinical, biological, radiological and pathological features of these 8 inflammatory pseudo-tumors. Results - All the patients (5 females and 3 males) presented a chronic infectious syndrome and/or previous history of chronic inflammatory disease. The correlation between biological, radiological and pathological aspects showed two distinctive types of inflammatory pseudo-tumors: a type revealed by a biological inflammatory syndrome, with a non encapsulated, heterogeneous and hypervascular lesion at imaging, and a dense fibroblastic inflammatory pseudo-tumor with portal endophlebitis on histology (n=5), and a type without inflammatory syndrome, with an encapsulated, homogeneous, hypovascular lesion at imaging and abundant necrosis on histology (n=3). Conclusion - The analysis of previous history of clinical, biological and radiological presentations, specially MRI, could predict the diagnosis of inflammatory lesion which must be confirmed by trans-parietal biopsy to avoid inappropriate radical hepotectomy.