Liu HB, Zhao LH, Zhang YJ, Li ZF, Li L, Huang QP. Left epigastric isolated tumor fed by the inferior phrenic artery diagnosed as ectopic hepatocellular carcinoma: A case report. World J Clin Cases 2023; 11(26): 6231-6239 [PMID: 37731571 DOI: 10.12998/wjcc.v11.i26.6231]
Corresponding Author of This Article
Qian-Peng Huang, MD, Associate Chief Physician, Department of General Surgery, Handan Central Hospital, No. 59 Congtai North Road, Congtai District, Handan 056008, Hebei Province, China. peng881223@126.com
Research Domain of This Article
Gastroenterology & Hepatology
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/
Hong-Bo Liu, Qian-Peng Huang, Department of General Surgery, Handan Central Hospital, Handan 056008, Hebei Province, China
Li-Hua Zhao, Department of Nursing, Affiliated Hospital of Hebei University of Engineering, Handan 056002, Hebei Province, China
Yong-Jian Zhang, Department of Gastroenterology, Affiliated Hospital of Hebei University of Engineering, Handan 056002, Hebei Province, China
Zhi-Feng Li, Department of General Surgery, Handan First Hospital, Handan 056000, Hebei Province, China
Lei Li, Department of General Surgery, Affiliated Hospital of Hebei University of Engineering, Handan 056002, Hebei Province, China
Author contributions: Huang QP contributed to conceptualization; Liu HB and Zhao LH conducted the immunohistochemical staining and drafted the original manuscript; Zhang YJ contributed to patient follow-up and monitoring; Li ZF contributed to interpretation of the results and visualization; Zhang YJ and Li L contributed to reviewing the manuscript and editing; Li L and Huang QP completed the operation; All of the authors have critically reviewed the manuscript and approved the final version; Liu HB and Zhao LH contributed equally to this paper and should be identified as co-first authors.
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 declare that they have no conflict of interest to disclose.
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: Qian-Peng Huang, MD, Associate Chief Physician, Department of General Surgery, Handan Central Hospital, No. 59 Congtai North Road, Congtai District, Handan 056008, Hebei Province, China. peng881223@126.com
Received: May 30, 2023 Peer-review started: May 30, 2023 First decision: July 17, 2023 Revised: July 30, 2023 Accepted: August 18, 2023 Article in press: August 18, 2023 Published online: September 16, 2023 Processing time: 100 Days and 20.3 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the most frequent cancers and the main cause of cancer-related death worldwide. Ectopic HCC, an extremely rare type of HCC, exhibits a wide range of clinical signs and radiographic features, making preoperative identification challenging.
CASE SUMMARY
A 47-year-old man underwent routine abdominal color ultrasonography, which identified an asymptomatic tumor in the left upper abdomen. The patient had no history of hepatitis, did not drink alcohol, and had no family history of cancer. Abdominal contrast-enhanced computed tomography (CT) revealed a heterogeneously enhanced lesion between the spleen and stomach that had invaded the diaphragm, with blood supplied by the left inferior phrenic artery. The patient underwent laparoscopic surgery, and HCC was identified by postoperative pathology. Additionally, specific immunohistochemical staining was performed to assess the molecular biological characteristics of the HCC. The patient underwent two rounds of hepatic arterial interventional chemotherapy after surgery. Abdominal plain and enhanced magnetic resonance imaging and lung CT 3 mo postoperatively revealed no signs of local recurrence or distant metastasis.
CONCLUSION
This asymptomatic ectopic HCC case described achieved an excellent result due to early detection, radical resection, and systematic surveillance.
Core Tip: Ectopic hepatocellular carcinoma (HCC) is relatively rare, and there is no acknowledged diagnostic or treatment standard for this type of tumor. Here, we describe a 47-year-old man with diaphragmatic invasion caused by a heterogeneously enhanced lesion between his spleen and stomach that was eventually diagnosed as HCC. We thoroughly describe the patient’s information, course of treatment, and excellent curative result.
