Q fever, a rare cause of secondary hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome in which Coxiella burnetii is a very infrequent etiology. We present the case of a 62-year-old male with progressive pulmonary infiltrates, fever, hepatitis, and bicytopenia despite broad spectrum antibiotics. A thorough clinical evaluation led to a high suspicion of Coxiella burnetii infection, subsequently confirmed through a positive serum polymerase chain reaction (PCR) analysis. HLH diagnosis was established based on the fulfillment of 5/8 diagnostic criteria, obviating the need for a bone marrow biopsy. Targeted antibiotic treatment and dexamethasone led to full recovery within two weeks, eliminating the need for stronger immunosuppressive therapy.

La identificación del riesgo de trastorno del aprendizaje de la lectura (dislexia) en 2° curso de educación infantil / Identification of risk of learning disabilities of reading (dyslexia) in 4-year-old children

Objetivo: Comprobar la eficacia predictora de dificultades de lectura del Test para la detección temprana de las dificultades en el aprendizaje de la lectura y escritura y de la Batería de iniciación a la lectura (BIL3-6). Método: Se aplicaron ambos instrumentos a alumnado de 2.° curso de Educación Infantil (107 participantes para el Test de detección temprana de las dificultades en el aprendizaje de la lectura y escritura y 211 para la BIL3-6), y dos años más tarde se evaluó su lectura por medio de la Lectura de Palabras y Pseudopalabras del Prolec-R y del Texto IB del TALE. También se obtuvo del profesorado una valoración del aprendizaje de los participantes. Resultados: Se calculó la sensibilidad (S) y la especificidad (E) de ambos instrumentos basándose en los agrupamientos del alumnado en función de los resultados en las tres tareas de lectura: buenos y malos lectores a partir del pc16. Ninguno de los dos instrumentos examinados alcanza unos valores adecuados de S y E. Si se toma a priori un valor adecuado de S para asegurar que se identifica al alumnado con riesgo de dificultades, entonces la E es muy baja y, por tanto, la cantidad de falsos positivos hace imposible adoptar decisiones educativas acertadas. La valoración general del profesorado sobre el aprendizaje de cada participante muestra similar capacidad predictiva que ambos instrumentos.(AU)

Objective: To check the predictive efficacy of subsequent reading difficulties of the Test for the early detection of difficulties in learning to read and write and the Battery for initiation to reading (BIL3-6). Method: Both instruments were applied to students in the 2nd year of Preschool (107 participants for the Early Detection Test and 209 for the BIL3-6), and 2 years later their reading was evaluated by reading Words and Pseudowords of the Prolec-R and Text IB of the TALE. An assessment of the participants’ learning was also obtained from the teachers. Results: The sensitivity (S) and specificity (E) of both instruments were calculated based on the groupings of the students based on the results in the 3 reading tasks: good and poor readers from pc16. Neither of the two instruments examined reach appropriate values of S and E. If an appropriate value of S is taken a priori to ensure that students at risk of difficulties are identified, then the E is very low, and therefore the number of false positives makes it impossible successful educational decisions. The general assessment of the teaching staff on the learning of each participant shows a similar predictive capacity as both instruments.(AU)

La lectura en alumnado hispanohablante con trastorno del desarrollo del lenguaje. Una revisión / Reading in Spanish-speaking students with developmental language disorder. A review

Los problemas de lectura parecen ser comunes en el trastorno del desarrollo del lenguaje (TDL). El objetivo de esta revisión es sintetizar la investigación sobre lectura en hispanohablantes con TDL. Para ello, se realizó una búsqueda en bases de datos y referencias de trabajos clave, seleccionando estudios con grupo de control. Cuando fue posible se realizó un metaanálisis de los datos encontrados. El nivel de lectura de los grupos con TDL fue significativamente inferior al de los grupos de edad similar con desarrollo típico del lenguaje (TE = -1.51). Las diferencias se apreciaron en comprensión, fluidez y precisión. Entre los estudios de intervención solo había uno con grupo de control equivalente. El alumnado hispanohablante con TDL muestra un nivel de lectura inferior al habitual en su edad. Se detectan carencias en la investigación en este campo, especialmente en intervención para la mejora de la lectura.(AU)

Reading problems appear to be common in developmental language disorder (DLD). The objective of this review is to synthesize the research on reading in Spanish speakers with DLD. A search was carried out in databases and references of key works, selecting studies with a control group. When possible, a meta-analysis of the data found was carried out. The reading level of the groups with DLD was significantly lower than that of the groups of similar age with typical language development (ES = -1.51). The differences were seen in comprehension, fluency and accuracy. Among the intervention studies there was only one with an equivalent control group. Spanish-speaking students with DLD show a reading level lower than usual for their age. Lacks are detected in research in this field, especially in intervention to improve reading.(AU)

Contemporary practice and perception of autologous blood salvage in hepato-pancreatico-biliary operations: an international survey.

BACKGROUND: This study aimed to assess contemporary knowledge, attitudes and behaviors around transfusion of intraoperative salvaged blood (sRBCt) during hepato-pancreatico-biliary (HPB) operations. Findings are meant to inform the design of future studies that address provider concerns to change behaviors and improve patient outcomes. METHODS: A survey was designed and assessed for relevance, readability and content, and distributed to an international audience of surgeons performing HPB operations. RESULTS: The 237 respondents were predominantly distributed across North America (37.55%), Europe (27.43%) and Asia (19.83%). Roughly one-half (52.74%) of respondents had used sRBCt in HPB surgery before. Transplantation surgeons were more likely than HPB surgeons to have previously used sRBCt [odds ratio = 5.18 (95% CI 1.89-14.20)]. More respondents believed sRBCt was safe for non-cancer versus cancer operations (68.57% vs. 24.17%, p < 0.0001). Less than half (45.71%) of respondents believed that sRBCt was safe in clean-contaminated fields. Most did not utilize preoperative strategies to avoid donor transfusion. CONCLUSION: Practices related to sRBCt in HPB operations vary widely and there is no consensus on its use. Concerns seem primarily related to cancer-specific and infectious outcomes. While further studies are pursued, surgeons may increase their utilization of preoperative strategies to boost hemoglobin levels for at risk patients.

Simple view of reading in Spanish: A longitudinal study / Concepción simple de la lectura en español: un estudio longitudinal

Objectives: Test the validity of the Simple View of Reading (Gough & Tunmer, 1986) in Spanish and analyze the contributions of decoding and linguistic abilities to reading comprehension. Method: This longitudinal study assessed a sample of 71 Spanish speaking children at Grade 1 and Grade 3. At each time point, a battery of tests assessed children's linguistic abilities, decoding and reading comprehension. The authors used the classic model of SVR: model 0 (pseudoword accuracy reading and listening comprehension) and a complex model: Model 1 (linguistic abilities and decoding). Results: Results of regression analyses showed that the original model of the SVR, explained little variance of reading comprehension in Spanish in comparison with the results obtained in English. However, a complex model explained 51% and 55% of the variance of reading comprehension in first and third grade respectively. The unique contribution of linguistic abilities increased from 27% in first grade to 43% in third grade and the contribution of decoding decreased from 24% in first grade to 2% in third grade. Conclusions: The results are explained in terms of the transparent nature of Spanish orthography and educational implications are discussed.(AU)

ObjetivosEvaluar la validez de la concepción simple de la lectura (Gough y Tunmer, 1986) en español y analizar la contribución de la decodificación y las habilidades lingüísticas a la comprensión lectora. Método: Se trata de un estudio longitudinal en el que se evaluó a 71 estudiantes hispanohablantes en 2 fases: en primer y en tercer curso de primaria. A todos ellos se les aplicó una serie de pruebas para evaluar las habilidades lingüísticas, la decodificación y la comprensión lectora en cada una de las fases. Los autores utilizaron el modelo original de la concepción simple de la lectura: modelo 0 (precisión en la lectura de seudopalabras y comprensión oral) y un modelo más abierto: modelo 1 (habilidades lingüísticas y decodificación). Resultados: Tras un análisis de regresión, se encontró que el modelo original de la concepción simple de la lectura explicó una varianza muy pequeña de la comprensión lectora en español en comparación los resultados obtenidos en inglés. Sin embargo, un modelo más abierto logró explicar el 51 y el 55% de la varianza de la comprensión lectora en el primer y el tercer curso de primaria, respectivamente. La contribución única de las habilidades lingüísticas se incrementó de un 27% en el primer curso a un 43% en el tercer curso y el aporte de la decodificación disminuyó de un 24% alcanzado en el primer curso a un 2% en el tercer curso. Conclusiones: Los resultados se explican en términos de la transparencia del sistema ortográfico del español. Los hallazgos tienen importantes implicaciones que son discutidas.(AU)

Prevalencia de hepatitis C en pacientes con trastornos psicóticos no afectivos / No disponible

INTRODUCCIÓN: nuestro objetivo fue determinar la prevalencia de infección por virus de la hepatitis C (VHC) en pacientes con trastornos psicóticos no afectivos y compararla con los datos poblacionales. MATERIAL Y MÉTODOS: se realizó un estudio observacional mediante la determinación de anti-VHC (RNA-VHC en los seropositivos) sobre 425 muestras séricas de pacientes con psicosis no afectiva. RESULTADOS: ocho pacientes presentaron anti-VHC positivo (1,9 %) y cinco, RNA-VHC detectable (1,2 %). La prevalencia de viremia fue significativamente mayor que la de la población general (OR 5,4; IC 95 %: 1,9-14,6). CONCLUSIONES: los pacientes con trastorno psicótico no afectivo presentan una prevalencia de infección activa superior a la población general y deberían ser objeto de un cribado sistemático

No disponible

Prevalence of hepatitis C in patients with non-affective psychotic disorders.

INTRODUCTION: the goal of this study was to determine the prevalence of hepatitis C virus (HCV) infection in patients with non-affective psychotic disorders and to compare it with population-based data. MATERIAL AND METHODS: an observational study was performed that measured anti-HCV antibodies (HCV-RNA in case of seropositivity) in 425 serum samples from patients with non-affective psychosis. Eight patients were positive for anti-HCV (1.9 %) and five had detectable HCV-RNA (1.2 %). The prevalence of viremia was significantly higher than in the general population (OR: 5.4; 95 % CI: 1.9-14.6). CONCLUSIONS: patients with non-affective psychotic disorder have a higher prevalence of active infection than that of the general population and should undergo systematic screening.

Atención escolar al trastorno por déficit de atención/hiperactividad en las comunidades españolas / School assistance for attention deficit hyperactivity disorder in the Spanish autonomous regions

Introducción. En los últimos años, distintas comunidades autónomas españolas han presentado políticas de atención escolar al trastorno por déficit de atención/hiperactividad (TDAH) o de coordinación entre los servicios de educación y sanidad, que se concretan en protocolos, instrucciones o guías de actuación. Objetivo. Conocer y comparar las propuestas de las distintas comunidades españolas para la atención escolar al TDAH. Sujetos y métodos. Tras una búsqueda de los documentos que recogen estas políticas, se analizó su información para poder compararlos en varias áreas: documento, ámbito de aplicación, detección del TDAH, diagnóstico, medidas escolares, seguimiento de las propuestas de la Guía de práctica clínica sobre el trastorno por déficit de atención/hiperactividad, fundamentación y recursos ofrecidos. Resultados. La Comunidad Valenciana es la única de la que no se ha encontrado documento alguno. No se analizó el de Baleares, por no ser público, y en las comunidades restantes se encuentran diferencias en el cumplimiento de los criterios valorados en cada área. Las políticas de Extremadura, Galicia, Cataluña y Navarra son las que cumplen el mayor número de criterios. Todas las comunidades con políticas sobre el TDAH proponen algún tipo de medida escolar y recursos como bibliografía, contactos o modelos de documentos o herramientas de detección. Todas, menos Madrid, ofrecen información sobre la detección y el diagnóstico del TDAH. Conclusión. Se constatan diferencias entre las propuestas de atención escolar al TDAH en España, y se identifican las de Extremadura, Galicia, Cataluña y Navarra como las más completas (AU)

Introduction. In recent years different Spanish autonomous regions have presented policies on school assistance for attention deficit hyperactivity disorder (ADHD) or coordination between the educational and healthcare services, which result in protocols, instructions or guidelines of action. Aim. To determine and compare the proposals put forward by the different Spanish regions with respect to school assistance for ADHD. Subjects and methods. After searching for the documents that contain these policies, the information therein was analysed with the aim of being able to compare them in several different areas: document, scope of application, detection of ADHD, diagnosis, school measures, follow-up of the proposals of the Guidelines on clinical practice in attention deficit hyperactivity disorder, grounds and resources offered. Results. The Valencian Region is the only one for which no documents were found. The document for the Balearic Islands was not analysed because it is not public, and in the other regions differences were found in the degree of compliance with the criteria assessed in each area. The policies in Extremadura, Galicia, Catalonia and Navarra are the ones that meet the largest number of criteria. All the regions with policies on ADHD propose some kind of school measures and resources such as bibliographical references, contacts or models of documents or screening tools. All of them, except Madrid, affer information about the detection and diagnosis of ADHD. Conclusion. There are differences among the proposals for school assistance for ADHD in Spain, and those of Extremadura, Galicia, Catalonia and Navarra are found to be the most complete (AU)

¿Sabemos cómo mejorar la comprensión? / Do we know how to improve the understanding?

No disponible

Eficacia de las intervenciones para el tratamiento de la dislexia: una revisión / Effectiveness of interventions for the treatment of dyslexia: a review

En este informe se revisa la investigación que respalda distintas intervenciones para el tratamiento de la dislexia, concretamente los trabajos de síntesis, en especial síntesis de las mejores evidencias, revisiones sistemáticas o metaanálisis publicados sobre cada tipo de intervención. En los casos en que no se ha publicado ningún trabajo de síntesis o estos trabajos son antiguos, se hace una revisión de la investigación primaria. Los trabajos localizados indican que los métodos fonológicos de intervención en la dislexia, es decir, aquellos en los que se combina el entrenamiento en habilidades fonológicas con el conocimiento de las letras y la práctica de la lectura, están ampliamente respaldados por la investigación. En cambio, la investigación sobre otros sistemas es sumamente escasa, ofrece resultados contradictorios o indica que se trata de sistemas ineficaces. Las intervenciones que están en estas situaciones son: la integración auditiva, el entrenamiento auditivo con soporte informático, la terapia visual, las lentes tintadas, el entrenamiento perceptivo-motor, las técnicas quiroprácticas, la integración sensorial, el método Davis, el neurofeedback, la musicoterapia y la educación musical o las dietas y suplementos alimenticios. A partir de esta revisión se realizan las siguientes recomendaciones: promocionar las intervenciones de tipo fonológico para el tratamiento de la dislexia, no utilizar o recomendar intervenciones que no estén respaldadas por la investigación científica, que los métodos de intervención que no hayan probado su eficacia no reciban el nombre de «terapia» o «tratamiento», y la creación y difusión de una guía sobre intervención en dislexia basada en evidencias científicas (AU)

In this report the research that supports various interventions for the treatment of dyslexia is revised, specifically the works of synthesis, especially synthesis of best evidence, systematic reviews or meta-analyses published about each type of intervention. A review of primary research is made in cases in which no synthesis work has been published or where these works are old. Localised works indicate that the phonological methods of intervention in dyslexia, i.e. those in which training in phonological skills is combined with knowledge of letters and the practice of reading, are widely supported by research. However, research on other methods is either extremely scarce or it offers conflicting results or it leads to the conclusion that they are inefficient methods. Interventions in this situation are: the auditory integration, the auditory training with computer support, visual therapy, the tinted lenses, motor-perceptual training, chiropractic techniques, sensory integration, the Davis method, neurofeedback, music therapy and music education or diets and dietary supplements. Promotion of phonological interventions is recommended; it is necessary to avoid recommendations of intervention methods for dyslexia which are not supported by scientific research; methods of intervention that have not proven their effectiveness may not be presented as therapies or treatments; and the creation and distribution of a guide on intervention in dyslexia based on scientific evidence is recommended (AU)

Laparoscopic ablation therapies or hepatic resection in cirrhotic patients with small hepatocellular carcinoma.

BACKGROUND: The Barcelona Clinic Liver Cancer staging system recommends radiofrequency ablation as treatment of choice for patients with "small" (up to 2 cm in size) hepatocellular carcinoma. AIMS: Aim of the study was to assess whether laparoscopic ablation therapies or hepatic resection could be proposed as alternative option if percutaneous approach is not feasible. METHODS: Overall survival and tumour recurrence rate were compared in a retrospective cohort of 176 consecutive patients with small hepatocellular carcinoma on cirrhosis treated by laparoscopic ablation therapies or surgery. To balance the covariates between the two groups, a propensity case-matched analysis was developed to generate a matched sample, which included 76 patients in each arm. RESULTS: Local tumour progression (p=0.005), intra-segmental recurrence (p=0.0001), and 5-year recurrence rates (80% vs. 60%; p=0.0014) were significantly higher in the ablation therapies group. The 5-year survival rate were 48% after ablation therapies and 69% after hepatic resection (p=0.0006). Multivariate analysis showed that MELD score, alpha-fetoprotein value, procedure category and intraoperative restaging were associated with survival, while the surgery was the only independent predictor of intra-hepatic recurrence. CONCLUSIONS: The present study suggests that, if percutaneous ablation is not feasible, hepatic resection may be considered as a sound option in the treatment of small hepatocellular carcinoma.

Liver resection for hepatocellular carcinoma in 313 Western patients: tumor biology and underlying liver rather than tumor size drive prognosis.

BACKGROUND & AIMS: Treatment decisions for hepatocellular carcinoma are mostly guided by tumor size. The aim of this study was to analyze resection outcomes according to tumor size and characterize prognostic factors. METHODS: Patients resected at a Western center between 1989 and 2010 were grouped by largest tumor size: <50mm, 50-100mm, and >100mm. The primary end points were overall- and recurrence-free survival. Univariate associations with primary endpoints were entered into a Cox proportional hazard regression model. RESULTS: Three hundred thirteen patients underwent resection: 111 (36%) had tumors <50mm, 113 (36%) had tumors between 50 and 100mm, and 89 (28%) had tumors >100mm. Five-year overall and disease-free survival rates for the three groups were 67%, 46%, and 34%, and 32%, 27%, and 27%, respectively. Thirty-five patients, mostly from <50mm group, underwent transplantation which was associated with a 91% 5 year survival rate. Tumor size was not an independent predictor of overall or recurrence-free survival on multivariate analyses. Independent predictors of decreased overall survival were: intraoperative transfusion (HR=2.60), cirrhosis (HR=2.42), poorly differentiated tumor (HR=2.04), satellite lesions (HR=1.69), alpha-fetoprotein >200 (HR=1.53), and microvascular invasion (HR=1.48). The use of salvage transplantation was an independent predictor of improved survival (HR=0.21). Recurrence-free survival was predicted by intraoperative transfusion (HR=2.15), poorly differentiated tumor (HR=1.87), microvascular invasion (HR=1.71) and cirrhosis (HR=1.69). CONCLUSION: By studying a large group of patients across a distribution of tumor sizes and background liver diseases, it is demonstrated that size alone is a limited prognostic factor. Tumor biology and condition of the underlying liver are better prognosticators and should be given closer attention. Although hampered by recurrence rates, resection is safe and offers good overall survival. In addition, it may allow for better selection for salvage transplantation after consideration of histopathological risk factors.

The simple view of reading in elementary school: a systematic review / La Concepción Simple de la Lectura en la Educación Primaria: una revisión sistemática

The simple view of reading (SVR) is a model that explains reading comprehension on the basis of two components: decoding and linguistic comprehension. The SVR model strongly influences current education practices, although its validity is still questioned. This review identified 56 studies on the three components of the SVR model in English-speaking children attending elementary school. A meta-analysis on these data showed that decoding and linguistic comprehension are moderately correlated, and that both decoding and linguistic comprehension are highly correlated with reading comprehension. Decoding and linguistic comprehension explain 50% of the variance of reading comprehension, and measurement error explains an additional 22%. Further research is needed to identify other variables that could predict reading comprehension after controlling for decoding and linguistic comprehension. Word reading accuracy was the assessment approach to decoding that best relates to reading comprehension. Various approaches to the assessment of linguistic comprehension produced similar results. In conclusion, reading comprehension is a more complex phenomenon than that described by the SVR model. However, decoding and linguistic comprehension, two variables that are simple to evaluate, provide a good approximation to reading comprehension measures for children in elementary school (AU)

La Concepción Simple de la Lectura (CSL) es un modelo que trata de explicar la comprensión lectora a partir de dos factores: la descodificación y la comprensión general del lenguaje. La CSL está teniendo una notable influencia en la práctica educativa aunque su validez aún se pone en duda. En esta revisión se identificaron cincuenta y seis investigaciones en las que se incluían los tres componentes de la CSL en alumnos de Educación Primaria hablantes de inglés. En el metanálisis de los datos obtenidos se encontró que había una correlación moderada entre descodificación y comprensión del lenguaje, y que ambas variables tenían una correlación alta con la comprensión lectora. La descodificación y la comprensión del lenguaje explicaban un 50% de la varianza de la comprensión lectora, y el error de medida explicaba un 22% adicional. Es necesaria más investigación sobre otras variables que puedan predecir la comprensión lectora tras controlar el efecto de la descodificación y la comprensión del lenguaje. La precisión en la lectura de palabras era la forma de evaluación de la descodificación que más se relacionaba con la comprensión lectora. Las distintas formas de medir la comprensión del lenguaje produjeron resultados similares. Se concluye que la comprensión lectora es un fenómeno más complejo que lo que se describe en la CSL. Sin embargo, la descodificación y la comprensión del lenguaje, que son variables fáciles de medir, permiten un buen acercamiento a la comprensión lectora de los alumnos de Educación Primaria (AU)

A foregut cystic neoplasm with diagnostic and therapeutic similarities to mucinous cystic neoplasms of the pancreas.

CONTEXT: Greater utilization of cross-sectional abdominal imaging has increased the diagnostic frequency of cystic neoplasms of the pancreas. The "International Consensus Guidelines 2012 for the Management of IPMN and MCN of the Pancreas" illustrates a diagnostic and therapeutic algorithm for these lesions based on current knowledge. CASE REPORT: We present a case of a 49-year-old woman with two years of intermittent epigastric pain found to have an 8.5 cm head of the pancreas mass on CT. Evaluation was consistent with a mucinous cystic neoplasm for which she underwent an uneventful pancreaticoduodenectomy. Histology revealed a bronchogenic cyst of the head of the pancreas. DISCUSSION: Bronchogenic cysts are congenital anomalies of the ventral foregut that can migrate into the abdomen prior to fusion of the diaphragm. They can easily be misdiagnosed for other benign and malignant retroperitoneal lesions. Similarly to mucinous cystic neoplasms, bronchogenic cysts have been reported to undergo malignant transformation. They can also become infected and hemorrhage. Therefore, resection should be performed in appropriate risk candidates. It is possible, with increased use of high resolution cross-sectional imaging, that these lesions may be identified with greater frequency in the abdomen and confused with other pancreatic neoplasms. The presence of ciliated respiratory epithelium and cartilage on pathology provides for definitive diagnosis.

[Inflammatory pseudotumor of the liver: a case of recurrence after resection]. / Pseudotumor inflamatorio del hígado: recurrencia después de la resección.

Inflammatory pseudo-tumor of the liver is a rare benign condition. Usually presented as a large liver mass, may cause obstruction or infiltration of the main vessels or biliary tree. The clinical presentation is mostly an inflammatory syndrome with acute abdominal pain. We present a 39-year-old female patient with abdominal pain, fever and jaundice. Images showed a 15-cm liver lesion in the left lobe of the liver. Malignancy could not be discarded and the patient underwent left hepatectomy. The histologic examination reported an inflammatory pseudo-tumor of the liver. The patient recurred after one year with the same symptoms and a 10-cm new lesion occupying segment I. Considered as a recurrence, medical treatment was decided tumor size decreased 50% after the first month and completely disappeared during the follow up. Two years later, the patient was readmitted with a new episode and a new 8-cm liver lesion in segment VII. She was treated again with anti-inflammatory medication and imaging control. Although inflammatory pseudo-tumor of the liver is a benign condition, it can have a recurrent behaviour. The differentiation with other malignant tumors sometimes is impossible by clinical and imaging presentation.

Pseudotumor inflamatorio del hígado: recurrencia después de la resección / [Inflammatory pseudotumor of the liver: a case of recurrence after resection].

Inflammatory pseudo-tumor of the liver is a rare benign condition. Usually presented as a large liver mass, may cause obstruction or infiltration of the main vessels or biliary tree. The clinical presentation is mostly an inflammatory syndrome with acute abdominal pain. We present a 39-year-old female patient with abdominal pain, fever and jaundice. Images showed a 15-cm liver lesion in the left lobe of the liver. Malignancy could not be discarded and the patient underwent left hepatectomy. The histologic examination reported an inflammatory pseudo-tumor of the liver. The patient recurred after one year with the same symptoms and a 10-cm new lesion occupying segment I. Considered as a recurrence, medical treatment was decided tumor size decreased 50

after the first month and completely disappeared during the follow up. Two years later, the patient was readmitted with a new episode and a new 8-cm liver lesion in segment VII. She was treated again with anti-inflammatory medication and imaging control. Although inflammatory pseudo-tumor of the liver is a benign condition, it can have a recurrent behaviour. The differentiation with other malignant tumors sometimes is impossible by clinical and imaging presentation.

Pseudotumor inflamatorio del hígado: recurrencia después de la resección. / [Inflammatory pseudotumor of the liver: a case of recurrence after resection].

Inflammatory pseudo-tumor of the liver is a rare benign condition. Usually presented as a large liver mass, may cause obstruction or infiltration of the main vessels or biliary tree. The clinical presentation is mostly an inflammatory syndrome with acute abdominal pain. We present a 39-year-old female patient with abdominal pain, fever and jaundice. Images showed a 15-cm liver lesion in the left lobe of the liver. Malignancy could not be discarded and the patient underwent left hepatectomy. The histologic examination reported an inflammatory pseudo-tumor of the liver. The patient recurred after one year with the same symptoms and a 10-cm new lesion occupying segment I. Considered as a recurrence, medical treatment was decided tumor size decreased 50

after the first month and completely disappeared during the follow up. Two years later, the patient was readmitted with a new episode and a new 8-cm liver lesion in segment VII. She was treated again with anti-inflammatory medication and imaging control. Although inflammatory pseudo-tumor of the liver is a benign condition, it can have a recurrent behaviour. The differentiation with other malignant tumors sometimes is impossible by clinical and imaging presentation.