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

Abstract

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.)

Ectopic hepatocellular carcinoma in the gallbladder

“…However, risk factors such as hepatitis B or C and cirrhosis seem more uncommon -in fact, only 32 % of ectopic liver cell carcinomas had a cirrhotic background (7), and two of 21 cases reported by Arakawa et al had positive viral serology (5), which suggests EL is of itself apt to undergo malignant transformation (6). The reasons for this greater degenerative ability remain unknown; however, deficient blood flow through the hepatic artery and an absent connection with the portal and biliary systems are thought to be triggering factors, possibly as a result of long-term exposure to carcinogenic substances (1,5,7).…”

Hepatocellular Cancer Arising From Ectopic Liver Tissue on Diaphragm in Association with Desmoid Mesenteric Tumor

“…The incomplete development of bile ducts leads to exposition to potentially carcinogenic agents [7].…”

Hepatocellular carcinoma in an ectopic Liver: CT findings

“…A follow-up CT scan at 7 months postoperatively revealed multiple HCCs in the mother liver. Only one case report in the international literature has, to the best of our knowledge, described the radiologic findings of HCC of an ectopic liver [1], and CT findings of both HCC in an ectopic liver, and recurrent HCC in the mother liver, have never been described.…”

“…The incidence of HCC originating from an ectopic liver is very low; between 1965 and 1999, only 23 cases were reported [1,2].…”