Park Yong-Eun
Department of Surgery, College of medicine, Yeungnam University, Daegu, Republic of Korea.
Case Rep Oncol. 2023 Aug 16;16(1):645-651. doi: 10.1159/000531842. eCollection 2023 Jan-Dec.
Ectopic hepatocellular carcinoma (HCC) can be defined as an HCC arising from hepatic parenchyma located in an extrahepatic organ or tissue. Fewer than 100 cases of ectopic liver have been reported. In 30 of these cases, HCC was detected in ectopic tissue. The author describes a case of ectopic HCC mimicking subepithelial tumor (SET) of the stomach successfully treated by laparoscopic resection. This case report also provides a pertinent review of the literature. A 61-year-old male was referred to our department for the management of an intra-abdominal mass found on abdominal computed tomography performed at a local medical center due to a 2-month history of vague abdominal pain. Abdominal magnetic resonance imaging and computed tomography showed a 7.2-cm sized heterogenous mass over the left subphrenic space adjacent to the stomach. Esophagogastroduodenoscopy showed a huge subepithelial mass at the fundus of the stomach. Based on the above findings, the diagnosis of SET of the stomach such as gastrointestinal stromal tumor or leiomyoma was suspected. Laparoscopic surgery was performed for definite diagnosis and treatment of the huge SET of the stomach. Histologic diagnosis was ectopic HCC of the trabecular type. Its histologic grade was consistent with Edmondson grade II. Although ectopic HCC is quite rare tumor of the stomach, it should be considered in the differential diagnosis of other abdominal mass-like lesions. Currently, with advances of laparoscopic surgery, laparoscopic resection for complete excision of ectopic HCC is possible with acceptable results.
异位肝细胞癌(HCC)可定义为起源于肝实质位于肝外器官或组织的HCC。报道的异位肝病例少于100例。其中30例在异位组织中检测到HCC。作者描述了一例通过腹腔镜切除成功治疗的酷似胃上皮下肿瘤(SET)的异位HCC病例。本病例报告还对相关文献进行了综述。一名61岁男性因2个月的腹部隐痛,在当地医疗中心进行腹部计算机断层扫描时发现腹腔内肿块,转诊至我科。腹部磁共振成像和计算机断层扫描显示左膈下间隙与胃相邻处有一个7.2厘米大小的异质性肿块。食管胃十二指肠镜检查显示胃底有一个巨大的上皮下肿块。基于上述发现,怀疑为胃SET,如胃肠道间质瘤或平滑肌瘤。为明确诊断和治疗胃巨大SET进行了腹腔镜手术。组织学诊断为小梁型异位HCC。其组织学分级与Edmondson II级一致。尽管异位HCC是胃的一种非常罕见的肿瘤,但在鉴别诊断其他腹部肿块样病变时应予以考虑。目前,随着腹腔镜手术的进展,通过腹腔镜切除完全切除异位HCC是可行的,且效果可接受。