Laparoscopic observations of congenital anomalies of the liver

Liver tissue ectopia is a well-documented phenomenon. Rarely, hepatocellular carcinoma arises from the ectopic liver tissue. In this paper, we report a case of a primary, well-differentiated hepatocellular carcinoma arising from ectopic liver tissue in the pancreas. The patient is a 58-year-old Hispanic man with no history of underlying liver diseases or chronic pancreatic diseases. Patient presented with a several days history of abdominal pain with radiation to his right upper quadrant. Imaging study revealed a 3.7 x 3.3-cm mass in the distal pancreas. No other lesions were identified. Preoperative fine needle aspiration revealed blood and atypical hepatocytes. The patient underwent distal pancreatectomy and splenectomy for suspected neuroendocrine tumor. Gross examination revealed a well-circumscribed 3.3-cm, beige-tan, pseudolobulated tumor with focal areas of hyperpigmentation. A microscopic examination revealed hepatoid cells arranged in a trabecular pattern with focal bile pigment. Immunohistochemistry study showed that the tumor cells were reactive with hepatocyte antigen (Hep par 1), alpha-1 antitrypsin, but negative for synaptophysin and chromogranin. Immunostain for polyclonal carcinoembryonic antigen showed a typical bile canalicular pattern. These results support that this tumor in the pancreas is hepatocellular carcinoma, most likely arising from ectopic liver tissue within the pancreas.

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“…The reported incidence of ectopic or accessory livers ranges from 0.47 to 0.7% with the gallbladder being the most common location [2,8,11].…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma arising from ectopic liver tissue in the pancreas

et al. 2007

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“…A range of defects has been identified, from simple windows to a complete absence of the falciform ligament 5. It is estimated that the incidence of falciform ligament defects is 0.3% 5…”

Section: Discussionmentioning

confidence: 99%

Transfalciform greater omental herniation

et al. 2017

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Internal herniae are rare, those involving the falciform ligament even rarer. To the best of our knowledge, there have been approximately 20 cases of herniae involving the falciform ligament previously reported. Of these cases, only one previously reported case involves herniation of the greater omentum through the falciform ligament. We present a second case of an adult man who presented with a 48-hour history of epigastric pain and was found on contrast multidetector CT to have a strangulated transfalciform greater omental hernia. The hernia was repaired laparoscopically and the patient recovered uneventfully.

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“…The most common pathologies include ligament cysts, tumors, and abnormal vascularization secondary to portal hypertension [3]. Additionally, the most recognized abnormalities of the falciform ligament are congenital pathologies including derivation and partial ligament defects [4]. It is well established that the arterial supply of the falciform ligament originates from a thin bundle branch of the right hepatic artery, which is anastomosed to the superficial inferior epigastric artery.…”

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Acute Abdomen: An Isolated Falciform Ligament Necrosis

Özkeçeci

Özsoy

Celep

et al. 2014

Case Reports in Emergency Medicine

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The falciform ligament is one of the anatomical structures which attach the liver to the diaphragm and anterior abdominal wall. Primary falciform ligament is very rare. In this article, we present a case of an isolated falciform ligament necrosis, a rare primary pathology of the falciform ligament, who was admitted with acute abdomen. Case presentation: A 64-year-old female patient was admitted with the complaints of pain. Laboratory test results showed a leukocyte count of 17,000/mm3. Imaging studies demonstrated intra-abdominal reactionary fluid along with a heterogeneous mass localized in the falciform ligament. Exploratory laparotomy revealed a necrotic mass of the falciform ligament. No other pathology responsible for falciform ligament necrosis was found. We believe that falciform ligament necrosis should be considered a preliminary diagnosis, if any ligament abnormality, tumor, intraligament air density, or the presence of reactionary fluid surrounding the ligament is detected through abdominal imaging studies.

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Laparoscopic observations of congenital anomalies of the liver

Cited by 88 publications

References 6 publications

Hepatocellular carcinoma arising from ectopic liver tissue in the pancreas

Hepatocellular carcinoma arising from ectopic liver tissue in the pancreas

Transfalciform greater omental herniation

A Rare Cause of Acute Abdomen: An Isolated Falciform Ligament Necrosis

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