Laparoscopic Resection of a Hepatocellular Carcinoma Arising from an Ectopic Liver

Abstract

Ectopic livers are rarely seen intra-abdominal lesions. Ectopic hepatocellular carcinoma (HCC) can be defined as an HCC arising from hepatic parenchyma located in an extrahepatic organ or tissue. The authors report a case of a primary, well-differentiated HCC arising from ectopic liver tissue in the left subphrenic space at the upper portion of the gastrorenal ligament that was successfully treated by laparoscopic resection. A 59-year-old man was referred to our department for the management of an intra-abdominal mass, which was incidentally found in a follow-up abdominal computed tomography scan for splenic laceration. The preoperative diagnosis suggested that it was a nonspecific stomach mass of maximal diameter 4.5 cm, such as, a gastrointestinal stromal tumor, located between the diaphragm and spleen. A computed tomography scan identified no mass in the liver. Laparoscopic resection was performed, and the final pathologic result confirmed that it was a HCC. The patient's postoperative course was unremarkable. This is the first reported case of a laparoscopically treated ectopic HCC. Moreover, laparoscopic resection was found to be safe and reliable in this case.

Giant ectopic liver, hepatocellular carcinoma and pachydermia-a rare genetic syndrome?

“…Fatty infiltration and alpha-1-antitrypsin deficiency have been described in ectopic liver [4,6]. However, the development of a hepatocellular carcinoma (HCC) in the ectopic liver is of utmost significance [7]. In fact, HCC can be observed in about 30% of ectopic livers [7].…”

“…However, the development of a hepatocellular carcinoma (HCC) in the ectopic liver is of utmost significance [7]. In fact, HCC can be observed in about 30% of ectopic livers [7]. The high incidence of neoplastic change in ectopic livers is explained probably by a different functional architecture with incomplete vascular and/or ductal systems.…”

Ectopic Hepatocellular Carcinoma Arising from the Peritoneum in a Patient with a History of Oropharyngeal Cancer: A Case Report

“…Although hemangioma, adenoma, nodular hyperplasia, and other benign lesions may arise, malignancies are more frequent in cases of ectopic liver [ 6 , 7 ]. Some reports have noted that ectopic hepatocellular carcinoma can be observed in about 7-30% of cases of ectopic liver [ 8 , 9 ]. The carcinogenetic factors in ectopic liver are poorly understood.…”

Ectopic Hepatocellular Carcinoma Arising in the Left Triangular Ligament of the Liver

“…Laparoscopic resection of HCC is a safe and feasible alternative to open surgery if the indications are appropriate [7]. As a result, two cases were thus identified, including the present case, of laparoscopically resected ectopic HCC [8]. …”