Kanzaki Ryu, Yamada Terumasa, Gotoh Kunihito, Takahashi Hidenori, Ohigashi Hiroaki, Ishikawa Osamu
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Case Rep Gastroenterol. 2010 May 12;4(2):138-143. doi: 10.1159/000314042.
Hepatocellular carcinoma (HCC) rarely originates in extrahepatic liver tissue. Laparoscopic resection is widely used to treat HCC. This report presents a case of a patient with ectopic HCC arising in the left triangular ligament of the liver that was successfully treated by laparoscopic resection. A 59-year-old female presented with an elevated serum alpha-fetoprotein (AFP) level (2,508 ng/ml). Dynamic computed tomography demonstrated a tumor measuring 20 mm in diameter below the left diaphragm just adjacent to the spleen. The tumor showed contrast enhancement in the hepatic arterial phase and became less dense than the liver parenchyma in the portal phase. The patient was diagnosed with ectopic HCC arising in the left diaphragm and laparoscopic surgery was performed. The tumor was located in the left triangular ligament of the liver and had a stalk between the tumor and the liver. The tumor was resected, and the final diagnosis was moderately differentiated ectopic HCC arising in the left triangular ligament of the liver. The patient had an uneventful postoperative recovery and has experienced no recurrence over 18 months after the operation.
肝细胞癌(HCC)很少起源于肝外肝脏组织。腹腔镜切除术广泛应用于HCC的治疗。本报告介绍了一例异位HCC患者,该肿瘤起源于肝脏左三角韧带,经腹腔镜切除成功治疗。一名59岁女性,血清甲胎蛋白(AFP)水平升高(2508 ng/ml)。动态计算机断层扫描显示,在左膈下紧邻脾脏处有一个直径20 mm的肿瘤。该肿瘤在肝动脉期呈强化表现,在门静脉期密度低于肝实质。患者被诊断为起源于左膈的异位HCC,并接受了腹腔镜手术。肿瘤位于肝脏左三角韧带,肿瘤与肝脏之间有蒂相连。肿瘤被切除,最终诊断为起源于肝脏左三角韧带的中分化异位HCC。患者术后恢复顺利,术后18个月无复发。