Diagnosis and surgical treatment of hepatic inflammatory myofibroblastic tumor

Abstract

Objective To analyze the clinical features and image manifestations of hepatic inflammatory myofibro-blastie tumor( HIMT), and to investigate the optimal management of this disease. Methods From January 2000 to January 2007, clinical data with HIMT verified by pathology were retrospectively analyzed. Results Eight patients 5 men, 3 women were included in the analysis. The mean age was 41.3 years. All eases did not have a history of previous hepatitis and liver cirrhosis, and 6 with no typical clinical symptoms. Hepatic functions, serum levels of AFP, CEA, CA199 in these patients were all within the normal ranges. Preoperative imaging by ultrasonography and computed tomography(CT) were not indicative of HIMT. Morphologic features by CT scan were summarized: at nonenhanced CT, the masses appeared as low density lesions. At contrast enhanced CT, the masses exhibited mod-erate intensification in the solitary areas, and the intensification peak appeared during the period of artery. During the period of portal vein and delayed scan, the masses showed low to moderate intensification in the solitary areas, in which the degree of intensification was a little lower than that in peripheral liver parenchyma. Gross specimens showed single solid masses, 3～12 cm, without classic envelope. All the patients underwent surgery whereas no incidence of perioperative death. Diagnosis of HIMT was confirmed by pathology of surgical specimens. Condusion Although typical presentation and the diagnostic workup are still lacking for HIMT, CT is helpful in diagnosing HIMT as well as combined with clinical findings. Surgical management would be likely the optimal treatment of this disease. Key words: inflammatory myofibroblastic tumor; liver tumors; diagnosis