Hepatocellular carcinoma arising in the abdominal cavity. An autopsy case of ectopic liver origin.

An unusual case of extrahepatic disseminating hepatocellular carcinoma in a 64-year-old man is reported. The initial symptom was abdominal fullness and progressive ascites. Alpha-fetoprotein in the serum was 117,000 ng/ml. Exploratory laparotomy disclosed dissemination of tumor nodules throughout the abdominal cavity without any other possible primary tumor. CT scan, ultrasonography and hepatic angiography were unable to detect any tumor lesion in the liver. The final histologic diagnosis was hepatocellular carcinoma, although at first epithelioid mesothelioma was suspected. The present case of hepatocellular carcinoma was thought to have possibly developed from ectopic liver on the peritoneum.