Inflammatory Pseudotumor of the liver mimicking peritoneal Carcinomatosis: a diagnostic challenge

Inflammatory pseudotumor of the liver is a rare benign entity with non-specific radiological features that can closely mimic malignant hepatic lesions, making its diagnosis challenging. We report the case of a patient in whom a focal hepatic lesion was detected on abdominal ultrasound, with imaging findings consistent with underlying cirrhosis. Subsequent contrast-enhanced computed tomography demonstrated a dysmorphic liver with infiltrative subcapsular hepatic masses, associated with micronodular infiltration of the peritoneal fat and cardiophrenic angle lymphadenopathy, raising strong suspicion for a malignant hepatic process with peritoneal carcinomatosis. The diagnosis of inflammatory pseudotumor was ultimately confirmed by a CT-guided percutaneous liver biopsy. This case emphasizes the importance of considering inflammatory pseudotumor in the differential diagnosis of hepatic lesions, as this entity may closely mimic malignant etiologies on imaging.