Ruptured Ectopic Hepatocellular Carcinoma Arising from the Left Subdiaphragm

ABSTRACT

Most hepatocellular carcinomas arise in orthotopic liver tissue as a result of chronic hepatitis B or C infection or cirrhosis secondary to other chronic liver disease. There have been reports of ectopic liver tissue located in an extrahepatic organ such as the gallbladder, spleen, hepatoduodenal ligament and subdiaphragm. However, the incidence of hepatocellular carcinoma originating from ectopic liver is very low. There have been 22 cases of ectopic HCCs (hepatocellular carcinoma) reported in the literature, and ruptured HCC has not yet been reported in the literature. As for the pathogenesis, the development of an ectopic HCC may be result of a compromised vascular supply or biliary drainage. We report here on a case of ruptured ectopic hepatocellular carcinoma arising in the left subdiaphragm in a 76-year-old man who was treated with surgical resection. The patient was followed up for 1 year after surgery and he remained free of recurrence. Therefore, the unique localization and growth pattern of ruptured ectopic HCC may give the physician and patient the chance to achieve a curative resection.