title: Giant ectopic liver, hepatocellular carcinoma and pachydermia-a rare genetic syndrome?
abstract: Ectopic liver is a very uncommon developmental anomaly that predisposes to the development of hepatocellular carcinoma. We describe the second documented case of a hepatocellular carcinoma developing in the primary liver of a patient with a rare and uncharacterized genetic symptom complex. Also present was the largest ectopic liver ever reported, measuring 12 cm in diameter which contained a solitary focus of metastatic hepatocellular carcinoma. The primary hepatocellular carcinoma is believed to have arisen in the native liver from a hepatic adenoma that was diagnosed 15 years earlier. The patient's uncharacterised condition featured prominent thick, yellow skin over the dorsum of the fingers, and was associated with follicular hyperkeratosis, abnormal plantar creases, digital clubbing, misshaped ears, a lingua plicata and an angioleiomyolipoma of the right kidney. This unique case of hepatocellular carcinoma arising from liver cell adenoma in a patient with an uncharacterised condition featuring a large ectopic liver invites discussion of the role of local factors in carcinogenesis in the parent liver but not the ectopic liver. It also underlines the imperative ongoing need for clinical autopsies.
authors.affiliation: Cantonal Institute of Pathology, Liestal, Switzerland. m.dettmer@gmx.net
authors.forename: Matthias
authors.initials: M
authors.lastname: Dettmer
authors.forename: Peter
authors.initials: P
authors.lastname: Itin
authors.forename: Peter
authors.initials: P
authors.lastname: Miny
authors.forename: Manoj
authors.initials: M
authors.lastname: Gandhi
authors.forename: Gieri
authors.initials: G
authors.lastname: Cathomas
authors.forename: Niels
authors.initials: N
authors.lastname: Willi
mesh_terms: D000015:Abnormalities, Multiple; D018248:Adenoma, Liver Cell / Q000175:diagnosis / Q000235:genetics*; D000328:Adult; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000235:genetics*; D002471:Cell Transformation, Neoplastic; D002828:Choristoma / Q000175:diagnosis / Q000235:genetics*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008099:Liver; D008113:Liver Neoplasms / Q000175:diagnosis / Q000235:genetics*; D010004:Osteoarthropathy, Primary Hypertrophic / Q000175:diagnosis / Q000235:genetics*; D013577:Syndrome; D013997:Time Factors