Inflammatory myofibroblastic tumors (IMTs) of the liver are extremely rare and account for just 0.7% of all hepatic lesions 1.
Refer to the article on inflammatory myofibroblastic tumors for a broad discussion.
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Epidemiology
IMTs of the liver are usually frequent in young adults and Asian people.
Etiology
Several conditions have been reported and associated with hepatic IMTs such as autoimmune diseases, IgG4 disease, sclerosing cholangitis, Crohn disease and hepatic viral infections like Epstein-Barr virus 2,3,4.
Clinical presentation
Hapatic IMTs are often present due to the compression effect on adjacent structures and may cause obstructive jaundice regarding size. They can also associated with a general inflammatory response such as fever and weight loss 5.
Radiographic features
CT
Hepatic IMTs may show homogeneous arterial enhancement with delayed washout and can mimic hepatocellular carcinomas. However, they usually show heterogeneous or peripheral arterial enhancement 6.
MRI
T1: low signal intensity
T2: usually high signal intensity
T1 C+ (Gd): often heterogeneous enhancement
Hepatobiliary contrast could help differentiate HCC from hepatic IMTs. High signal intensity in the center of the lesion on the hepatobiliary phase, suggesting a benign lesion 6.
Treatment
In isolated hepatic IMT,s surgical resection is the most accepted treatment 7.
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