Qin MQ, Zhao YP, Xie JP. Ectopic adrenal gland in the liver leading to a misdiagnosis of hepatocellular carcinoma: A case report. World J Hepatol 2025; 17(8): 108443 [DOI: 10.4254/wjh.v17.i8.108443]
Corresponding Author of This Article
Ju-Ping Xie, MMed, Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, No. 628 Zhenyuan Road, Guangming (New) District, Shenzhen 518107, Guangdong Province, China. xiejuping@sysush.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2025; 17(8): 108443 Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.108443
Ectopic adrenal gland in the liver leading to a misdiagnosis of hepatocellular carcinoma: A case report
Min-Qiu Qin, Yi-Peng Zhao, Ju-Ping Xie
Min-Qiu Qin, Department of Health and Rehabilitation, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Yi-Peng Zhao, Department of Pathology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Ju-Ping Xie, Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Author contributions: Qin MQ and Xie JP analyzed the data and wrote the manuscript; Zhao YP provided and analyzed pathology images; Xie JP contributed to the investigation (clinical management, and follow-up).
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ju-Ping Xie, MMed, Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, No. 628 Zhenyuan Road, Guangming (New) District, Shenzhen 518107, Guangdong Province, China. xiejuping@sysush.com
Received: April 15, 2025 Revised: May 26, 2025 Accepted: July 14, 2025 Published online: August 27, 2025 Processing time: 135 Days and 4.1 Hours
Abstract
BACKGROUND
Adrenal ectopia is a rare condition in which adrenal tissue is found in an abnormal location, often posing diagnostic challenges. Although generally considered benign, it can present as hepatic or other organ lesions, mimicking malignant tumors. In the liver, ectopic adrenal tissue can closely resemble hepatocellular carcinoma or metastatic disease, potentially leading to unnecessary aggressive treatments such as surgery or chemotherapy. Consequently, a high index of suspicion is essential to avoid misdiagnosis and ensure appropriate management.
CASE SUMMARY
In this case report, we present a 53-year-old male with ectopic adrenal tissue in the liver, mimicking a potential hepatic malignancy. Based on computed tomography and magnetic resonance imaging findings, which suggested a malignant liver lesion and a left adrenal adenoma, the patient underwent laparoscopic partial hepatectomy under general anesthesia. Intraoperatively, no signs of liver cirrhosis were observed. An intraoperative ultrasound identified a 1.2 cm hypoechoic nodule in segment 7 of the liver. Dissection of the right adrenal gland revealed that the nodule had infiltrated the hepatic parenchyma, confirming the presence of ectopic adrenal tissue. Frozen section pathology revealed proliferating adrenal tissue. The patient recovered smoothly and was discharged 10 days postoperatively.
CONCLUSION
This case report underscores the importance of considering adrenal ectopia in the differential diagnosis of liver lesions, especially when imaging findings suggest malignancy.
Core Tip: This rare case describes ectopic adrenal tissue in the liver mimicking malignancy in a 53-year-old male with adrenal adenoma. Imaging revealed a hepatic lesion prompting resection; histopathology confirmed adrenal ectopia, excluding malignancy. It underscores adrenal ectopia as a critical differential in liver masses, particularly with adrenal disorders, to prevent misdiagnosis. Multidisciplinary evaluation integrating imaging and histology is essential. The case enhances understanding of adrenal ectopia’s pathophysiology and highlights its consideration in adrenal-hepatic pathologies, optimizing diagnostic accuracy and treatment outcomes.
