HEPATOCELLULAR CARCINOMA ARISING IN THE ABDOMINAL CAVITY. An Autopsy Case of Ectopic Liver Origin

Kawahara, Ei; Kitamura, Teruo; Ueda, Hiroshi; Ogino, Tomomi; Mai, Masayoshi; Ooi, Akishi; Nakanishi, Isao

doi:10.1111/j.1440-1827.1988.tb02297.x

Cited by 13 publications

(7 citation statements)

References 17 publications

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“…We distinguish between ectopic liver, which is outside the liver proper without any connection to it, and accessory liver, which is connected to the liver, often by a stalk [5]. Ectopic livers are islands of normal liver parenchyma separated from the main lobes of the liver and can occur at various sites near the liver, such as the gallbladder, intra-abdominal ligaments, omentum, retroperitoneum and thorax [1, 2, 3]. Ectopic liver is usually found incidentally, but it may also be found because of neoplastic change or compressive effects.…”

Section: Discussionmentioning

confidence: 99%

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Multiple Ectopic Hepatocellular Carcinomas Arising in the Abdominal Cavity

Miyake

Hoshino

Yoshida

et al. 2012

Case Rep Gastroenterol

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Ectopic hepatocellular carcinoma (HCC) is a very rare clinical entity that is defined as HCC arising from extrahepatic liver tissue. This report presents a case of ectopic multiple HCC arising in the abdominal cavity. A 42-year-old otherwise healthy male presented with liver dysfunction at a general health checkup. Both HCV antibody and hepatitis B surface antigen were negative. Laboratory examination showed elevations in serum alpha-fetoprotein and PIVKA-II. Ultrasonography and computed tomography revealed multiple nodular lesions in the abdominal cavity with ascites without a possible primary tumor. Exploratory laparoscopy was performed, which revealed bloody ascites and multiple brown nodular tumors measuring approximately 10 mm in size that were disseminated on the perineum and mesentery. A postoperative PET-CT scan was performed but it did not reveal any evidence of a tumor in the liver. The tumors resected from the peritoneum were diagnosed as HCC. The present case of HCC was thought to have possibly developed from ectopic liver on the peritoneum or mesentery.

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Section: Discussionmentioning

confidence: 99%

“…Ectopic liver tissue develops at various sites near the liver, such as the gallbladder, intra-abdominal ligaments, omentum, retroperitoneum and thorax [1, 2, 3]. The incidence of ectopic liver tissue has been reported to be 0.24–0.47% [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Multiple Ectopic Hepatocellular Carcinomas Arising in the Abdominal Cavity

Miyake

Hoshino

Yoshida

et al. 2012

Case Rep Gastroenterol

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“…1, 1999 Review of the Literature. There have been 21 cases reported in the literature, mostly from Japan (as listed in Table 1), [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] of HCC arising extrahepatically. In all these cases, the mother liver did not have HCC.…”

Section: Casementioning

confidence: 99%

Propensity of ectopic liver to hepatocarcinogenesis: Case reports and a review of the literature

Arakawa

Kimura²,

Sakata³

et al. 1999

Hepatology

148

178

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Two patients with ectopic liver are described. In one patient, a small ectopic liver attached to the gastric serosa developed hepatocellular carcinoma (HCC). The preoperative diagnosis was an ␣-fetoprotein (AFP)-producing carcinoma and a malignant ulcer of the stomach. Total gastrectomy and esophago-jejunostomy were performed. The tumor that measured 4 ؋ 2 ؋ 2 cm contained an AFP-producing HCC and normal liver tissue. In another patient who had alcoholic cirrhosis, ectopic liver on the serosa of the gallbladder was found to have the same histological changes as the mother liver. A survey of the literature disclosed more than 20 cases in which HCC developed outside the liver; the liver did not have HCC. By contrast, there was only one report on HCC occurring in the liver in the presence of a noncancerous, relatively large accessory liver lobe. Because ectopic liver does not have a complete vascular and ductal system as a normal liver, it is perhaps functionally handicapped and more prone to hepatocarcinogenesis. (HEPATOLOGY 1999;29:57-61.)

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“…Ectopic liver is also histologically often identical to bona fide liver tissue or may show identical pathological changes seen as normal orthotopic liver. Fatty infiltration, alcoholic cirrhosis, haemosiderosis and primary hepatocellular carcinoma have been reported in ectopic liver, along with secondary malignancy [3,7,8,20,21]. For the first time, we report a case of alpha 1-antitrypsin retention with radiologic correlation, and macroscopic and microscopic images in an ectopic liver, adding to the list of pathological abnormalities that may be seen in an ectopic liver.…”

Section: Discussionmentioning

confidence: 95%

Alpha 1-antitrypsin retention in an ectopic liver

2011

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Ectopic livers are infrequently reported in the literature. The reported size for ectopic livers range from a few millimeters up to several centimeters. They are often clinically silent and incidentally discovered during imaging of the hepatobiliary tract, regional surgical procedures or autopsy. They are predestined for benign liver diseases otherwise observed in normal livers like fatty change or develop malignancies such as hepatocellular carcinoma, in a manner analogous to the parent orthotopic liver. The presence of abnormal alpha 1-antitrypsin retention in an ectopic liver has, to our knowledge, not been reported in the literature. Hereby, we present the first reported case featuring alpha 1-antitrypsin retention in an ectopic liver attached to the fundus of the gallbladder and present the clinical, radiological and pathological findings in a caucasian woman undergoing cholecystectomy for acute cholecystitis. Special liver stains showed an alpha 1-antitrypsin retention which was confirmed immunohistochemically. Although ectopic livers are rare and usually an incidental finding, the radiologist and the surgeon should take this into the differential diagnosis of a mass attached to the gall bladder. A secondary disease should be considered by the pathologist in such a specimen and alpha 1-antitrypsin retention should be ruled out by special liver stains. Finally, such a finding should prompt the managing clinician to exclude systemic alpha-1 antitrypsin deficiency in the patient through further appropriate tests.

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HEPATOCELLULAR CARCINOMA ARISING IN THE ABDOMINAL CAVITY. An Autopsy Case of Ectopic Liver Origin

Cited by 13 publications

References 17 publications

Multiple Ectopic Hepatocellular Carcinomas Arising in the Abdominal Cavity

Multiple Ectopic Hepatocellular Carcinomas Arising in the Abdominal Cavity

Propensity of ectopic liver to hepatocarcinogenesis: Case reports and a review of the literature

Alpha 1-antitrypsin retention in an ectopic liver

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