A rare presentation of atypical fissures associated with an unusual accessory liver lobe

Abstract

BackgroundHepatic variations are common in the general population with one of the most prevalent variations being the presence of abnormal fissures. Accessory lobes (ALs) of the liver are rare occurrences, and the vessels associated with these lobes are rarely discussed. Case presentationUnique morphological variations were observed in the liver of an 81-year-old male cadaver during routine dissection. Five accessory liver fissures (ALFs) and an AL, seen on the visceral surface, were observed on the liver. Three ALFs located on the diaphragmatic surface were characteristic of a corset liver. The remaining two ALFs presented as two oblique lines on the visceral surface, one on the right lobe and one on the left lobe. The AL was located between the quadrate lobe (QL) and caudate lobe (CL) and maintained a connection to the QL via liver parenchyma. The hepatic triad associated with this AL was composed of a direct branch from the right hepatic artery, a direct branch from the left portal vein, and a component of the biliary system leading to the left hepatic duct. There was also a tributary to the middle hepatic vein directly associated with the AL. These basic elements suggest that the AL is an independent functional hepatic segment. ConclusionDue to its presentation, the AL could be misdiagnosed as a tumor during imaging, which prompts removal surgically. The location of this AL, in regards to the hepatic circulatory system, can compromise its flow resulting in symptoms relating to portal hypertension/injuries. Thus, the presence of this novel AL is particularly significant in the fields of surgery and diagnostic imaging.