Her Scans Looked Like Cancer Spreading Through Her Abdomen, but a Liver Biopsy Found a Benign Impostor

4,000 Brigham and Women’s Nurses Postpone Wednesday Strike to Vote on Hospital’s Best and Final Contract OfferBrigham and Women’s nurses postponed the Oct. 14 strike to vote on a final offer. See the pay, insurance, and staffing terms, and what patients face. Parents Should Check Amazon Bath Seats and Dressers, Giant Bike Lock Keys, and Avengers Medals in New RecallsNew CPSC recalls cover Amazon baby bath seats and dressers, Giant LED bike lock keys, and Avengers medals. See what you own and how to get refunds. Chicago Marathon’s Record Field of More Than 55,000 Faces a Yellow-Flag Day with Highs Near 71 DegreesThe Chicago Marathon starts under a yellow flag with a forecast high near 71, above the 65-degree normal. Heat illness signs and when to stop. Records Detail Immediate Jeopardy Citation After Charlotte Nursing Home Resident in Wheelchair Was Fatally Struck in 2023Records show inspectors cited a Charlotte nursing home at the immediate jeopardy level after a resident in a wheelchair was fatally struck on a busy road. Mental Health The Brain’s So-Called Christmas Spirit Network Lit Up in 10 Holiday Lovers, but Red Pictures Might Explain ItAn fMRI study found five brain regions responded more to Christmas images in people who celebrate, but the authors admitted red may be to blame. Frequent Mental Distress in Adults 18 to 29 Climbed From 12.7% to 21.3% Since 2012 Despite Recent DeclinesCDC data show 1 in 5 adults 18 to 29 report frequent mental distress, up from 2012 but down two years straight. Where to find help today. A Strong Smell Could Set Off His Sneezing Fits, but His Muscles Told a Stranger StoryStrong smells set off a teacher’s sneeze-like fits for nine years. Muscle recordings showed rapid jerks unlike a textbook sneeze reflex. Louisiana Finds New Synthetic Opioid Cychlorphine in at Least Two Deaths, Warns Extra Naloxone Doses May Be NeededLouisiana found cychlorphine in at least two overdose deaths since December 2025. See where the opioid has spread and why naloxone may need repeating. Innovation AI Chatbots Failed to Urge Emergency Care in About 41% of Vietnamese Scenarios Versus 15% in EnglishA simulated test presented at ACG 2026 found that AI chatbots missed urgent GI warnings far more often in Vietnamese. What families should know. AI Tool Helped Neurology Residents Tell Epilepsy From Functional Seizures Correctly Up to 89% of the TimeA University of Minnesota AI tool reads clinical notes to help doctors tell epilepsy from functional seizures. What it found and why it isn’t ready. A Medical Paper Called a 37-Year-Old Study Recent, and Nearly 1 in 5 Recent Citations Were at Least a Decade OldA BMJ analysis of 1,000 papers found 17.7% of references labeled recent were at least 10 years old, and some dated back as far as 37 years. No Measles, Mumps or Chickenpox Cases Followed Accidental Live Vaccines in 220 IBD Patients on Immune-Modifying DrugsNo measles, mumps, or chickenpox cases followed accidental live vaccine administration in 220 IBD patients on immunosuppressive drugs. Why live shots are still avoided. Healthy Living Isaias Outages Left Gulf Coast Fridges Warm for Days: Which Groceries to Toss and Which to KeepAfter Isaias, Gulf Coast families face costly fridge decisions. See which foods USDA charts say to toss, which can stay, and where help may exist. Only 40% of Americans Have Strong Confidence in Hospitals and Clinics While 52% Trust Science a LotNew Wellcome data show Americans trust science more than most nations but doubt hospitals. What patients say drives the gap and what can help. San Francisco Expands Doxy-PEP to Women and Others as Officials Report 24% Drop in Syphilis CasesSan Francisco now offers the after-sex antibiotic doxy-PEP to more people as syphilis and chlamydia rates fall. What it is, who qualifies, and the risks. Queens Pharmacy Owner Arrested Trying to Board One-Way Toronto Flight in Alleged $31 Million HIV Medicaid FraudA Jackson Heights pharmacy owner faces fraud charges over HIV drug kickbacks and buybacks. What patients and taxpayers need to know about the case. Covid – 19 FDA Proposes Requiring Companies to Report Food Additives That Now Reach Grocery Shelves Without Federal ReviewFDA has released its proposed GRAS rule requiring companies to notify the agency about food additives. Here is what the proposal does and does not do. Federal Regulators Warn Some Hair Dryer Brushes Lack the Part That Stops ElectrocutionCPSC warns hair dryer brushes sold on Walmart.com and TikTok Shop lack immersion protection. The seller has not agreed to a recall or refund. A Recalled Teething Toy Broke the Pattern Parents Were Told to Look ForA newly recalled pull-string teething toy has a different model number and design from earlier recalls, and one choking incident has been reported. Trying to Lower Blood Sugar, Cholesterol or Blood Pressure? Different Workouts Suited Different MarkersA pooled analysis of 53 trials found that different exercise types helped different metabolic markers. Most of the evidence was low certainty. Editorial Illustration via AI Share on Twitter Share on Facebook Share on Pocket The imaging looked grim. A 39-year-old woman had large, irregular masses in her liver, small nodules scattered across the lining of her abdomen, and enlarged lymph nodes near her heart. Radiologists strongly suspected a cancer that had spread across the abdominal lining, a pattern called peritoneal carcinomatosis.

A needle biopsy found no cancer at all. Instead, the mass was an inflammatory pseudotumor, a rare benign lesion made of scar-forming cells and inflammatory cells that can closely imitate malignancy on scans.

The case was published Oct. 4 in Oxford Medical Case Reports by radiologists in the emergency radiology department at Avicenne Hospital, Mohammed V University, in Rabat, Morocco.

According to the report, the woman had no known medical history. She came to the hospital with pain in her right lower back and upper middle abdomen. She had no fever, but her liver was enlarged and tender. Blood tests showed only mild liver abnormalities, including moderately raised levels of two liver enzymes, while bilirubin, kidney function, and inflammatory markers were normal. Tumor markers were not tested.

An ultrasound showed a misshapen liver with features suggesting cirrhosis, several poorly defined lesions beneath the liver’s surface, and a small amount of fluid in the abdomen. A contrast CT scan then revealed multiple infiltrating masses. The largest, in the right lobe, measured about 15 by 5 by 14 centimeters. It wrapped around branches of the portal vein, the vessel that carries blood from the intestines to the liver, which remained open, and touched the gallbladder and duodenum without clearly invading them.

The scan also showed nodules on the liver surface, tiny nodules in the abdominal lining, mild fluid buildup, and enlarged lymph nodes in the right cardiophrenic angle, a space just above the diaphragm beside the heart. Some lesions had central areas that looked like dead tissue. Taken together, the authors wrote, the picture raised strong suspicion of cancer with peritoneal spread.

A CT-guided needle biopsy targeted the liver lesion. Under the microscope, pathologists saw a proliferation of fibroblasts and myofibroblasts, the cells involved in scarring and wound repair, with no abnormal features. They sat in dense, scar-like tissue mixed with a variety of inflammatory cells. There were no cancer cells.

The diagnosis was hepatic inflammatory pseudotumor. Because the biopsy sampled only the lesion, it could neither confirm nor rule out the cirrhosis suggested on imaging.

The authors acknowledged important gaps. Testing for ALK, a protein marker that helps distinguish inflammatory pseudotumor from a related tumor called inflammatory myofibroblastic tumor, was not performed. Testing for IgG4, which can point to a related immune condition, was also not done. And the woman was lost to follow-up after her diagnosis, so it is unknown whether her lesions shrank, grew, or needed treatment.

Inflammatory pseudotumors occur most often in the lungs, and liver involvement is rare, the authors note. About 15.6% of patients have no symptoms at all, and tumor markers are usually normal. A 2011 review described the liver form as a rare entity often mistaken for cancer, and its cause remains unknown. Proposed triggers include infections, autoimmune processes, and chronic liver and bile duct disease.

A multicenter study of 45 patients treated at three South Korean hospitals from 1995 to 2011 found that CT and MRI offered clues but no defining features, so tissue diagnosis was needed. Tumor markers were normal in 93.3% of those patients. Ten underwent surgery, and none had a recurrence.

Peritoneal involvement makes the deception even more convincing. The authors found only a few published cases of liver pseudotumors with lesions in the peritoneum, the membrane lining the abdomen, or the omentum, a fatty apron of tissue that hangs over the intestines.

Background liver disease adds another layer of difficulty. People with cirrhosis face a higher risk of liver cancer, according to the National Cancer Institute, so an unusual mass in a cirrhotic-appearing liver is reasonably treated as suspicious.

The authors called histopathology, the microscopic study of tissue, the cornerstone of diagnosis. “Image-guided biopsy is recommended for indeterminate lesions to establish diagnosis and avoid unnecessary surgery,” they wrote.

Once cancer has been ruled out, management is not standardized. According to the authors, some lesions shrink on their own, while others respond to anti-inflammatory drugs or antibiotics. In the Korean study, 35 patients were managed without surgery, 20 of them with antibiotics, and every one who had follow-up imaging showed shrinkage or complete resolution.

The case does not mean that suspicious liver scans are usually benign. Imaging findings that look like spreading cancer still require urgent evaluation. But it shows why a tissue diagnosis matters before major treatment decisions. Patients facing a concerning scan can ask their care team whether a biopsy or specialist review is appropriate before treatment begins.

A 39-year-old woman had liver masses, abdominal nodules, and enlarged lymph nodes that strongly suggested spreading cancer. A biopsy instead showed a benign inflammatory pseudotumor.

What is an inflammatory pseudotumor of the liver?

It is a rare, noncancerous mass made of scar-forming cells and inflammatory cells. Its cause is not fully understood.

It formed large, irregular masses with areas resembling dead tissue, alongside abdominal nodules and enlarged lymph nodes, features commonly seen when cancer spreads.

Imaging cannot reliably tell it apart from cancer. A biopsy examined under a microscope is needed to confirm it.

There is no standard approach. After cancer is ruled out, some lesions shrink on their own, while others are treated with anti-inflammatory drugs or antibiotics.

She was lost to follow-up, so her outcome is unknown. Some confirmatory tests, including ALK and IgG4 testing, were also not performed.