Primary Hepatocellular Carcinoma in Ectopic Liver and Later Metastasis to Mother Liver: A Case Report and Review of the Literature

Abstract

We are presenting a case of primary ectopic hepatocellular carcinoma (HCC) that later developed HCC in the mother liver during long-term follow-up. A 64-year-old woman presented with a sudden onset of abdominal pain and internal bleeding. Ectopic HCC was diagnosed by the surgical resection of 2 tumors during laparotomy, which were found near the triangular ligament and lesser curvature of the stomach. Imaging studies revealed no intrahepatic lesion or peritoneal tumors during follow-up. However, 2 small HCCs in the mother liver were detected two years after surgery without peritoneal recurrence. Progressive alpha-fetoprotein elevation was noted despite the complete ablation of the mother liver HCC by image study. Recurrent peritoneal HCC carcinomatosis was detected and confirmed by exploratory laparotomy two years later. The patient died because of disease progression seven years after the peritoneal tumors resection without HCC recurrence in the mother liver. A literature review disclosed 7 ectopic HCC cases, including the present one, who developed mother liver HCC during the follow-up period. Regular serum AFP level monitoring and image studies are recommended for detecting recurrent or metastatic HCC after tumor resection.