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Case Reports
. 2013 Oct 14;19(38):6485-9.
doi: 10.3748/wjg.v19.i38.6485.

Ectopic liver: different manifestations, one solution

Pavel Zonca  1 , Lubomir Martinek, Peter Ihnat, Jan Fleege
Affiliations
Case Reports

Ectopic liver: different manifestations, one solution

Pavel Zonca et al. World J Gastroenterol. .

Abstract

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.

Keywords: Diagnostic; Ectopic; Hepatocellular carcinoma; Liver; Treatment.

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Figures

Figure 1
Figure 1
Small oval tumor (3 cm × 2 cm × 2 cm) was found in the ligamentum hepatoumbilicalis next to the liver.
Figure 2
Figure 2
Histopathology of the tumor from the ligamentum hepatoumbilicalis (liver tissue with moderate steatosis and a thick fibrotic capsule).
Figure 3
Figure 3
Tumor (10 cm × 8 cm × 6 cm) on the upper pole of the spleen. A: Computed tomography scan, arterial phase with a coronal reconstruction; B: Computed tomography scan, arterial phase - axial orientation.
Figure 4
Figure 4
Histopathology of the hepatocellular carcinoma found in an ectopic liver in the spleen.
See this image and copyright information in PMC

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