title: [A case ectopic hepatocellular carcinoma with peritoneal dissemination].
abstract: An 83-year-old man was admitted to our hospital for further investigation of liver dysfunction. Laboratory examination revealed serum alpha-fetoprotein (AFP) levels of 4205ng/ml, an AFP/AFP-L3 ratio of 32.3%, an indocyanine green retention rate at 15 minutes of 25.9%, and negative serology for viral hepatitis. Ultrasonography, contrast-enhanced computed tomography, and magnetic resonance imaging revealed an early enhanced tumor measuring approximately 3cm at its maximal dimension. The tumor contacted segment 6 of the liver, and there was no other specific space-occupying lesion in the liver. Detailed angiography revealed that the tumor received its blood supply from the gastroduodenal artery. A diagnosis of ectopic hepatocellular carcinoma was made and laparoscopy with partial liver resection was performed. Intraoperative findings revealed a small amount of bloody ascites and peritoneal dissemination. The tumor, which was attached to the liver, was resected. Histopathologically, the tumor was a moderately differentiated hepatocellular carcinoma without connection to the liver parenchyma. A final diagnosis of ectopic hepatocellular carcinoma accompanied by peritoneal dissemination was thus confirmed.
authors.affiliation: Department of Hepato-Biliary Pancreatic Surgery, Tokyo Medical and Dental University.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakamura
authors.forename: Takumi
authors.initials: T
authors.lastname: Irie
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
mesh_terms: D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002828:Choristoma / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D010529:Peritoneal Cavity / Q000473:pathology*