title: Ectopic liver: different manifestations, one solution.
abstract: Developmental abnormalities are rare in the liver. This study presents two case reports of ectopic liver. The first case was a 31-year-old male with clinical indication for laparoscopic appendectomy. Laparoscopy identified a perforated appendix and an unknown tumorous lesion in the ligamentum hepato umbilicalis. The patient underwent a laparoscopic appendectomy, intraoperative lavage of the peritoneal cavity, and extirpation of the lesion in the ligamentum hepato umbilicalis. Histopathological examination of the excised tumor revealed that it comprised liver tissue with fibrinous changes. The tumor was completely separate from the liver with no connection. It was classified as an ectopic liver. No further therapy was required. The second case was a 59-year-old male with a tumor on the upper pole of the spleen, incidentally diagnosed in an ultrasound examination. The biopsy raised suspicion of hepatocellular carcinoma. A positron emission tomography-computed tomography examination revealed accumulation of F-18 fluorodeoxyglucose only in the tumor. The patient underwent a splenectomy with a resection and reconstruction of diaphragm. After the hepatocellular carcinoma was confirmed, adjuvant therapy (sorafenib) was initialized. The operations and postoperative recoveries were uncomplicated in both cases. Despite the low incidence of ectopic liver and rare complications, it is necessary to maintain awareness of this possibility. The potential malignancy risk for ectopic liver tissue is the basis for radical surgical removal. Therapy for hepatocellular carcinoma in an ectopic liver follows the same guidelines as those followed for treating the "mother" liver.
authors.affiliation: Pavel Zonca, Lubomir Martinek, Peter Ihnat, Department of Surgery, University Hospital Ostrava, 70852 Ostrava, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Zonca
authors.forename: Lubomir
authors.initials: L
authors.lastname: Martinek
authors.forename: Peter
authors.initials: P
authors.lastname: Ihnat
authors.forename: Jan
authors.initials: J
authors.lastname: Fleege
mesh_terms: D000328:Adult; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000601:surgery; D002828:Choristoma / Q000175:diagnosis* / Q000601:surgery; D004240:Diverticulum / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D033162:Incidental Findings; D008099:Liver; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Diagnostic; Ectopic; Hepatocellular carcinoma; Liver; Treatment