Al-Handola Rami, Chinnappan Justine, Bakeer Mohammad, Ayad Sarah
Internal Medicine, Hurley Medical Center, Michigan State University College of Human Medicine, Flint, USA.
Cureus. 2023 Jun 20;15(6):e40683. doi: 10.7759/cureus.40683. eCollection 2023 Jun.
Riedel's lobe is a rare anatomical variant of the liver morphology with a downward tongue-like projection of the anterior edge of the right lobe. It is usually detected incidentally with abdominal imaging performed for other indications. We present a case where we found Riedel's lobe incidentally, with invasive adenocarcinoma arising from close proximity. A 64-year-old female came in with encephalopathy and was found to have a distended abdomen with tenderness. Imaging revealed a complex lobular mass in the right hepatic lobe with an elongated extension of the right lobe inferiorly consistent with Riedel's lobe. The differential considered was malignancy versus abscess. CT-guided biopsy revealed invasive adenocarcinoma consistent with intrahepatic cholangiocarcinoma, which was further supported by the presence of portocaval lymph nodes. Various studies have tried to establish an association between Riedel's lobe and the occurrence of cancer arising from the surrounding structures, primarily from liver or metastasis. This case report adds to the current literature when such an association is being studied.
里德尔叶是一种罕见的肝脏形态解剖变异，表现为右叶前缘向下的舌状突出。通常在因其他指征进行腹部成像检查时偶然发现。我们报告一例偶然发现里德尔叶且在其附近发生浸润性腺癌的病例。一名64岁女性因脑病前来就诊，发现腹部膨隆且有压痛。影像学检查显示右肝叶有一个复杂的小叶状肿块，右叶向下有一个细长延伸，符合里德尔叶表现。鉴别诊断考虑为恶性肿瘤与脓肿。CT引导下活检显示为浸润性腺癌，符合肝内胆管癌，肝门腔静脉淋巴结的存在进一步支持了这一诊断。各种研究试图建立里德尔叶与周围结构（主要是肝脏或转移灶）发生癌症之间的关联。本病例报告为正在研究这种关联的当前文献增添了内容。
