Ectopic hepatocellular carcinoma mimicking a retroperitoneal tumor: A case report

Adachi, Yuki; Hayashi, Hiromitsu; Yusa, Toshihiko; Takematsu, Toru; Matsumura, Kazuki; Higashi, Taishi; Yamamura, Kensuke; Yamao, Takanobu; Imai, Katsunori; Yamashita, Yo Ichi

doi:10.3748/wjg.v26.i18.2268

Cited by 16 publications

(26 citation statements)

References 21 publications

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“…Only 3 of the 27 patients underwent fine needle aspiration (FNA). Two of three cases were diagnosed with EHCC before treatment or operation ( 3 , 14 , 16 ). Therefore, FNA could be an effective detection tool when a tumor cannot be classified.…”

Section: Discussionmentioning

confidence: 99%

“…Included cases must provide confirmed pathological images, follow-up examination, and treatment methods. In the end, 27 cases were available for the criteria (including our case) ( 3 , 5 – 27 ). Among these cases, male to female ratio was 2:1.…”

Section: Literature Reviewmentioning

confidence: 99%

“…The finding of ectopic liver accidentally happens in abdominal surgery and autopsy. It develops in various locations such as the gallbladder, intra-abdominal ligaments, omentum, peritoneum, retroperitoneum, and thorax ( 1 – 3 ). Nevertheless, lesions have a tendency to develop into hepatoma without mother liver malignancy.…”

Section: Introductionmentioning

confidence: 99%

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Challenge in Diagnosis and Treatment of Ectopic Hepatocellular Carcinoma: A Case Report and Literature Review

Liu

Pan

et al. 2022

Front. Surg.

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BackgroundFindings of ectopic hepatocellular carcinoma (EHCC) have been rarely documented. Complicated clinical features and unpredictable medical prognosis make diagnosis and treatment difficult.Case PresentationWe reported a 59-year-old male patient who came to the hospital with epigastric discomfort and regurgitation of gastric acid. An enhanced CT scan revealed a 1.8 cm × 1.4 cm mass in the tail of pancreas without any positive finding in the liver. Postoperative MRI scan was performed but did not reveal any evidence of hepatic tumor. The tumor was resected in toto. Meanwhile, a 1 cm × 1 cm mass in the body of the stomach was found that was removed simultaneously. Histopathology showed that the pancreatic tumor was ectopic hepatocellular carcinoma (EHCC), and that the gastric nodule was gastrointestinal stromal tumor (GIST). The patient had an uneventful postoperative recovery. He has been living without recurrence for over 7 years since surgery. Owing to our knowledge, this is the second-longest disease-free survival time for EHCC in the literature.ConclusionHere, we present a rare case of EHCC in the pancreas, and review the current literature on EHCC. Operation was an effective treatment for patients with curable EHCC. EHCC with metastasis still needs more practice to improve the poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Challenge in Diagnosis and Treatment of Ectopic Hepatocellular Carcinoma: A Case Report and Literature Review

Liu

Pan

et al. 2022

Front. Surg.

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“…EL harbors an increased risk of malignant transformation, with reported rates of *12% to 30% (Refs. 5,[17][18][19] ). This increased risk is likely due to the lack of native vasculature and inability of bile excursion.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, the fucosylated form of serum AFP, AFP-L3, which is more specific for HCC, was measured in four studies in the literature, and was elevated in all four. 19,[25][26][27] Definitive treatment of these lesions includes surgical excision and prognosis is excellent. 5,14,20 Therefore, management of these lesions should mirror that of small localized HCC in the native liver without cirrhosis followed by surveillance.…”

Section: Discussionmentioning

confidence: 99%

Robotic Distal Pancreatectomy and Splenectomy for an Intrapancreatic Hepatocellular Carcinoma: A Case Report and Review of the Literature

Vining

Hsu

Schuitevoerder

et al. 2020

Journal of Pancreatic Cancer

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Background: Liver parenchyma that resides outside of the normal hepatic confines is defined as accessory liver if in communication with the native biliary tree, or ectopic liver (EL) if it is not. EL can develop in a variety of tissues, including but not limited to the gallbladder, the hepatic ligaments, the pancreas, and retroperitoneum. EL has an increased propensity for malignant degeneration resulting in hepatocellular carcinoma (HCC). Presentation: A 67-year-old Korean male presented with epigastric discomfort and was found to have an elevation in his transaminases. Cross-sectional imaging demonstrated a 1.3 cm solid mass in the body of the pancreas with features concerning for either a pancreatic ductal adenocarcinoma or pancreatic neuroendocrine tumor. Subsequent endoscopic ultrasound and fine needle aspiration demonstrated cells of epithelial origin with hepatocellular differentiation. A robotic-assisted distal pancreatectomy and splenectomy was performed with final pathology demonstrating a well-differentiated HCC. Conclusions: EL with malignant degeneration resulting in HCC requires surgical excision. The majority of patients reported with EL resulting in HCC in the pancreas have had the tumors located in the body and tail. Therefore, definitive treatment requires distal pancreatectomy and splenectomy. Herein, we describe the presentation, workup, and definitive treatment of HCC arising in the pancreas.

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Ectopic lesions in the abdomen and pelvis: a multimodality pictorial review

Kim

Sim

et al. 2022

Abdom Radiol

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Ectopic hepatocellular carcinoma mimicking a retroperitoneal tumor: A case report

Cited by 16 publications

References 21 publications

Challenge in Diagnosis and Treatment of Ectopic Hepatocellular Carcinoma: A Case Report and Literature Review

Challenge in Diagnosis and Treatment of Ectopic Hepatocellular Carcinoma: A Case Report and Literature Review

Robotic Distal Pancreatectomy and Splenectomy for an Intrapancreatic Hepatocellular Carcinoma: A Case Report and Review of the Literature

Ectopic lesions in the abdomen and pelvis: a multimodality pictorial review

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