Pavel Zonca, Lubomir Martinek, Peter Ihnat, Department of Surgery, University Hospital Ostrava, 70852 Ostrava, Czech Republic.
World J Gastroenterol. 2013 Oct 14;19(38):6485-9. doi: 10.3748/wjg.v19.i38.6485.
Developmental abnormalities are rare in the liver. This study presents two case reports of ectopic liver. The first case was a 31-year-old male with clinical indication for laparoscopic appendectomy. Laparoscopy identified a perforated appendix and an unknown tumorous lesion in the ligamentum hepato umbilicalis. The patient underwent a laparoscopic appendectomy, intraoperative lavage of the peritoneal cavity, and extirpation of the lesion in the ligamentum hepato umbilicalis. Histopathological examination of the excised tumor revealed that it comprised liver tissue with fibrinous changes. The tumor was completely separate from the liver with no connection. It was classified as an ectopic liver. No further therapy was required. The second case was a 59-year-old male with a tumor on the upper pole of the spleen, incidentally diagnosed in an ultrasound examination. The biopsy raised suspicion of hepatocellular carcinoma. A positron emission tomography-computed tomography examination revealed accumulation of F-18 fluorodeoxyglucose only in the tumor. The patient underwent a splenectomy with a resection and reconstruction of diaphragm. After the hepatocellular carcinoma was confirmed, adjuvant therapy (sorafenib) was initialized. The operations and postoperative recoveries were uncomplicated in both cases. Despite the low incidence of ectopic liver and rare complications, it is necessary to maintain awareness of this possibility. The potential malignancy risk for ectopic liver tissue is the basis for radical surgical removal. Therapy for hepatocellular carcinoma in an ectopic liver follows the same guidelines as those followed for treating the "mother" liver.
发育异常在肝脏中很少见。本研究报告了两例异位肝的病例报告。第一例是一名 31 岁男性，因临床指征行腹腔镜阑尾切除术。腹腔镜检查发现阑尾穿孔和脐肝韧带处有一个未知的肿瘤性病变。患者接受了腹腔镜阑尾切除术、腹腔灌洗和脐肝韧带病变切除术。切除肿瘤的组织病理学检查显示，它由具有纤维蛋白变化的肝组织组成。肿瘤与肝脏完全分离，没有连接。它被归类为异位肝。无需进一步治疗。第二例是一名 59 岁男性，在上极脾上偶然发现一个肿瘤，在超声检查中诊断。活检提示肝细胞癌。正电子发射断层扫描-计算机断层扫描检查显示 F-18 氟脱氧葡萄糖仅在肿瘤中积聚。患者接受了脾切除术，同时切除和重建膈肌。在确认肝细胞癌后，开始辅助治疗（索拉非尼）。这两个病例的手术和术后恢复都很顺利。尽管异位肝的发病率低且并发症罕见，但仍需保持对此种可能性的认识。异位肝组织的潜在恶性风险是彻底手术切除的基础。异位肝的肝细胞癌治疗遵循与治疗“母”肝相同的指南。
