Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica
Inflammatory pseudotumors of the liver are rare, non-neoplastic liver tumors. Due to the nonspecific clinical presentation, imaging features, and histopathological findings, they can mimic malignant tumors requiring invasive diagnostics. We present a case of a 61-year-old female patient with a histo...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-01-01
|
| Series: | Journal of Investigative Medicine High Impact Case Reports |
| Online Access: | https://doi.org/10.1177/23247096211070387 |
| _version_ | 1819282632420098048 |
|---|---|
| author | Gowthami Kanagalingam MD Khadija N. Dulymamode MD, MBA Abtin Jafroodifar MD Syed A. Huda MD Adriana May MD Umair Masood MD Savio John MD |
| author_facet | Gowthami Kanagalingam MD Khadija N. Dulymamode MD, MBA Abtin Jafroodifar MD Syed A. Huda MD Adriana May MD Umair Masood MD Savio John MD |
| author_sort | Gowthami Kanagalingam MD |
| collection | DOAJ |
| description | Inflammatory pseudotumors of the liver are rare, non-neoplastic liver tumors. Due to the nonspecific clinical presentation, imaging features, and histopathological findings, they can mimic malignant tumors requiring invasive diagnostics. We present a case of a 61-year-old female patient with a history of type 2 diabetes mellitus, hypothyroidism, hyperlipidemia, and polymyalgia rheumatica who had initially presented with abdominal pain for 3 weeks. Further workup showed normal liver chemistries and tumor markers: AFP and CA 19-9. Magnetic resonance imaging (MRI) of the abdomen showed a segment 6 lesion measuring 4.1 × 4.0 × 3.7 cm. A liver biopsy then confirmed the diagnosis of an inflammatory pseudotumor of the liver with negative IgG4. On follow-up imaging, a rapid growth of this liver lesion was noted. Laparoscopy was done but did not show any distinct liver lesion. Follow-up imaging confirmed a decrease in the size of the mass. Interestingly, the patient had been on a higher dose of steroids for her polymyalgia rheumatic leading up to the follow-up imaging. This is the first case of an inflammatory pseudotumor of the liver in a patient with polymyalgia rheumatica. With this case, we would like to increase the awareness for inflammatory pseudotumors of the liver as a differential diagnosis of liver lesions in patients with underlying autoimmune disorders. |
| first_indexed | 2024-12-24T01:18:40Z |
| format | Article |
| id | doaj.art-942759a6596c4dea83777baf72d2aace |
| institution | Directory Open Access Journal |
| issn | 2324-7096 |
| language | English |
| last_indexed | 2024-12-24T01:18:40Z |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| spelling | doaj.art-942759a6596c4dea83777baf72d2aace2022-12-21T17:22:42ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962022-01-011010.1177/23247096211070387Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia RheumaticaGowthami Kanagalingam MD0Khadija N. Dulymamode MD, MBA1Abtin Jafroodifar MD2Syed A. Huda MD3Adriana May MD4Umair Masood MD5Savio John MD6Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USASt. George’s University School of Medicine, Grenada, West IndiesDepartment of Radiology, SUNY Upstate Medical University, Syracuse, NY, USADepartment of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USADepartment of Pathology, SUNY Upstate Medical University, Syracuse, NY, USADepartment of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USADepartment of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USAInflammatory pseudotumors of the liver are rare, non-neoplastic liver tumors. Due to the nonspecific clinical presentation, imaging features, and histopathological findings, they can mimic malignant tumors requiring invasive diagnostics. We present a case of a 61-year-old female patient with a history of type 2 diabetes mellitus, hypothyroidism, hyperlipidemia, and polymyalgia rheumatica who had initially presented with abdominal pain for 3 weeks. Further workup showed normal liver chemistries and tumor markers: AFP and CA 19-9. Magnetic resonance imaging (MRI) of the abdomen showed a segment 6 lesion measuring 4.1 × 4.0 × 3.7 cm. A liver biopsy then confirmed the diagnosis of an inflammatory pseudotumor of the liver with negative IgG4. On follow-up imaging, a rapid growth of this liver lesion was noted. Laparoscopy was done but did not show any distinct liver lesion. Follow-up imaging confirmed a decrease in the size of the mass. Interestingly, the patient had been on a higher dose of steroids for her polymyalgia rheumatic leading up to the follow-up imaging. This is the first case of an inflammatory pseudotumor of the liver in a patient with polymyalgia rheumatica. With this case, we would like to increase the awareness for inflammatory pseudotumors of the liver as a differential diagnosis of liver lesions in patients with underlying autoimmune disorders.https://doi.org/10.1177/23247096211070387 |
| spellingShingle | Gowthami Kanagalingam MD Khadija N. Dulymamode MD, MBA Abtin Jafroodifar MD Syed A. Huda MD Adriana May MD Umair Masood MD Savio John MD Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica Journal of Investigative Medicine High Impact Case Reports |
| title | Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica |
| title_full | Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica |
| title_fullStr | Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica |
| title_full_unstemmed | Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica |
| title_short | Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica |
| title_sort | enlarging liver mass inflammatory pseudotumor in a patient with polymyalgia rheumatica |
| url | https://doi.org/10.1177/23247096211070387 |
| work_keys_str_mv | AT gowthamikanagalingammd enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica AT khadijandulymamodemdmba enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica AT abtinjafroodifarmd enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica AT syedahudamd enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica AT adrianamaymd enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica AT umairmasoodmd enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica AT saviojohnmd enlarginglivermassinflammatorypseudotumorinapatientwithpolymyalgiarheumatica |