Published online Nov 15, 2022. doi: 10.4251/wjgo.v14.i11.2288
Peer-review started: August 16, 2022
First decision: September 23, 2022
Revised: September 28, 2022
Accepted: October 17, 2022
Article in press: October 17, 2022
Published online: November 15, 2022
Processing time: 90 Days and 20.1 Hours
Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is rare with a low malignant potential. Hepatic IPT-like FDCS has similar clinical features to hepatocellular carcinoma (HCC), making it extremely difficult to distinguish between them in clinical practice. We describe the case of a young female patient diagnosed with HCC before surgery, which was pathologically diagnosed as IPT-like FDCS after the left half of the liver was resected. During 6 mo of follow-up, the patient recovered well with no signs of recurrence or metastasis.
A 23-year-old female patient with a 2-year history of hepatitis B presented to the Affiliated Hospital of Guizhou Medical University. She was asymptomatic at presentation, and the findings from routine laboratory examinations were normal except for slightly elevated alpha-fetoprotein levels. However, ultrasonography revealed a 3-cm diameter mass in the left hepatic lobe, and abdominal contrast-enhanced computed tomography revealed that the tumor had asymmetrical enhancement during the arterial phase, which declined during the portal venous phase, and had a pseudo-capsule appearance. Based on the findings from clinical assessments and imaging, the patient was diagnosed with HCC, for which she was hospitalized and had undergone laparoscopic left hepatectomy. However, the tumor specimens submitted for pathological analyses revealed IPT-like FDCS. After surgical removal of the tumor, the patient recovered. In addition, the patient continued to recover well during 6 mo of follow-up.
Hepatic IPT-like FDCS is difficult to distinguish from HCC. Hepatectomy may provide beneficial outcomes in non-metastatic hepatic IPT-like FDCS.
Core Tip: Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a type of FDCS with low malignant potential. We investigated the clinical and pathological characteristics, diagnosis, and treatment in a 23-year-old woman diagnosed with hepatic IPT-like FDCS. She underwent laparoscopic left hepatectomy, with an uneventful postoperative course. It is difficult to distinguish hepatic IPT-like FDCS from hepatocellular carcinoma based on clinical features. Therefore, most patients with hepatic IPT-like FDCS are found after surgery. However, surgery may be the best treatment option for patients with hepatic IPT-like FDCS. At present, no abnormality has been found in the patient during the 6-mo follow-up.