Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6485
Revised: July 5, 2013
Accepted: July 12, 2013
Published online: October 14, 2013
Processing time: 147 Days and 18.5 Hours
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. Histpathological 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.
Core tip: Ectopic liver presents a rare clinical finding resulting from liver tissue migration to various organs during embryogenesis. Although the condition is typically asymptomatic, it can lead to different clinical manifestations such as intraabdominal bleeding or hepatocarcinogenesis. The potential malignancy risk is the basis for radical surgical removal; which represents the only correct solution. Therapy for hepatocellular carcinoma in an ectopic liver follows the same guidelines (National Comprehensive Cancer Network Guidelines) as those followed for treating the “mother” liver. Despite the low incidence of ectopic liver and rare complications, it is necessary to maintain an awareness of this possibility.