Liu Hong-Bo, Zhao Li-Hua, Zhang Yong-Jian, Li Zhi-Feng, Li Lei, Huang Qian-Peng
Department of General Surgery, Handan Central Hospital, Handan 056008, Hebei Province, China.
Department of Nursing, Affiliated Hospital of Hebei University of Engineering, Handan 056002, Hebei Province, China.
World J Clin Cases. 2023 Sep 16;11(26):6231-6239. doi: 10.12998/wjcc.v11.i26.6231.
Hepatocellular carcinoma (HCC) is one of the most frequent cancers and the main cause of cancer-related death worldwide. Ectopic HCC, an extremely rare type of HCC, exhibits a wide range of clinical signs and radiographic features, making preoperative identification challenging.
A 47-year-old man underwent routine abdominal color ultrasonography, which identified an asymptomatic tumor in the left upper abdomen. The patient had no history of hepatitis, did not drink alcohol, and had no family history of cancer. Abdominal contrast-enhanced computed tomography (CT) revealed a heterogeneously enhanced lesion between the spleen and stomach that had invaded the diaphragm, with blood supplied by the left inferior phrenic artery. The patient underwent laparoscopic surgery, and HCC was identified by postoperative pathology. Additionally, specific immunohistochemical staining was performed to assess the molecular biological characteristics of the HCC. The patient underwent two rounds of hepatic arterial interventional chemotherapy after surgery. Abdominal plain and enhanced magnetic resonance imaging and lung CT 3 mo postoperatively revealed no signs of local recurrence or distant metastasis.
This asymptomatic ectopic HCC case described achieved an excellent result due to early detection, radical resection, and systematic surveillance.
肝细胞癌（HCC）是全球最常见的癌症之一，也是癌症相关死亡的主要原因。异位HCC是一种极其罕见的HCC类型，表现出广泛的临床症状和影像学特征，术前识别具有挑战性。
一名47岁男性接受常规腹部彩色超声检查，发现左上腹有一个无症状肿瘤。该患者无肝炎病史，不饮酒，也无癌症家族史。腹部增强计算机断层扫描（CT）显示脾脏和胃之间有一个不均匀强化的病变，已侵犯膈肌，由左下膈动脉供血。患者接受了腹腔镜手术，术后病理确诊为HCC。此外，还进行了特异性免疫组化染色以评估HCC的分子生物学特征。患者术后接受了两轮肝动脉介入化疗。术后3个月的腹部平扫及增强磁共振成像和肺部CT显示无局部复发或远处转移迹象。
该例无症状异位HCC病例因早期发现、根治性切除和系统监测而取得了良好的效果。
