An unusual hepatic lesion in a patient following radical surgery of rectal cancer

Chemotherapy-induced hepatic pseudotumor has not been reported before. A 69-year-old female was admitted for a newly detected hepatic lesion after radical resection and chemotherapy for the advanced rectal cancer patient (pT4aN1aM1). Further radiological examinations, including contrast-enhanced CT, Gd-EOB-DTPA-enhanced MRI and ultrasound, could not exclude the possibility of liver malignancy. Laparoscopic complete resection of the lesion was performed. Histopathological examination showed scattered multinucleated giant cell response, focal fibrous tissue hyperplasia between lobules, local necrosis with granuloma formation, and collagen nodule formation. Acid-fast and Periodic acid–Schiff (PAS) stains were negative. Neither malignant evidence was found nor sufficient evidence to diagnose a benign liver lesion that fit into the current classification system of a benign hepatic tumour. The final diagnosis of chemotherapy-induced pseudotumor was made using the opinions of pathologists, surgeons and oncologists. No recurrence occurred during the 12-months follow-up. In conclusion, surgical resection should still be the first choice for newly detected liver lesions after chemotherapy of colorectal cancer. Hepatic pseudotumor could be triggered by chemotherapy as a form of hepatic injury.