Inflammatory pseudo-tumoral primary hepatic tuberculosis: a surgeons dilemma

Pseudo-tumor hepatic tuberculosis is a rare entity. Tuberculosis involving the liver in the absence of active pulmonary tuberculosis is very uncommon. It is characterized by non-specific symptoms and radiological polymorphism. This case report illustrates the difficulty in reaching the correct diagnosis in case of hepatic masses, which are most often confused with carcinoma of the liver, primary or metastatic and hence, in the past referred to as pseudo-tumoral hepatic tuberculosis. We report a case of an inflammatory pseudo-tumor of the liver due to tuberculosis in a 6 years child. Computer tomography showed evidence of a large heterogenously enhancing predominantly cystic multiseptated mass in left lobe of liver with peripheral nodular enhancement and persistent enhancement of internal septations and nodular solid components. Hence malignant tumor was initially considered in view of the radiological findings. Alpha fetoprotein was within normal limits. The patient was treated surgically by debridement of left lobe of liver.