Left epigastric isolated tumor fed by the inferior phrenic artery diagnosed as ectopic hepatocellular carcinoma: A case report

Figure 1 Abdominal enhanced computed tomography showing a tumor with heterogeneous enhancement. A: Diaphragmatic parietal level; B: Bottom heart level; C: Upper pole level of spleen; D: Esophageal hiatus level; E: Spleen hilar level; F: Lower pole level of tumor (Arterial phase).

Figure 2 Operative findings and gross view of the surgical specimen. A: The right liver lobe; B: The left liver lobe; C: The tumor with capsule formation and diaphragm invasion; D: Diaphragmatic wound after tumor resection; E: Macroscopic images of the tumor; F: Cross-sectional images of the tumor.

Figure 3  Hepatic arteriography showing no microscopic tumors in the liver.

Figure 4  The patient’s α-fetoprotein levels over time.

Figure 5 Postoperative enhanced magnetic resonance imaging of the upper abdomen. A: Plain phase; B: Arterial phase; C: Portal phase; D: Extended phase.

Figure 6 Microscopic findings of the tumor. A: Hematoxylin and eosin (HE)-stained slide (HE, × 40); B: Hepatocyte antigen (+); C: Arginase-1 (+); D: α-fetoprotein (+); E: Inhibin-α (-); F: Cytokeratin (CK) (-); G: Glypican-3 (+); H: Ki-67 (hot regions: 5%) (+); I: CK19 (-); J: CK8/18 (-); K: Hepatocyte paraffin-1 (+); L: Programmed death-ligand 1 (-).