Supplementary Material for: Laparoscopically resected ectopic hepatocellular carcinoma mimicking subepithelial tumor of stomach: A case report

Ectopic hepatocellular carcinoma (HCC) can be defined as an HCC arising from hepatic parenchyma located in an extrahepatic organ or tissue. Fewer than 100 cases of ectopic liver have been reported. In 30 of these cases, HCC was detected in an ectopic tissue. The author describes a case of ectopic HCC mimicking subepithelial tumor (SET) of stomach successfully treated by laparoscopic resection. This case report also provides, a pertinent review of the literature. A 61-year-old male was referred to our department for the management of an intra-abdominal mass found at abdominal computed tomography performed at a local medical center due to a 2-month history of vague abdominal pain. Abdominal magnetic resonance imaging and computed tomography showed a 7.2cm sized heterogenous mass over the left sub-phrenic space adjacent to the stomach. Esophagogastroduodenoscopy showed a huge subepithelial mass at fundus of stomach. Based on the above findings, the diagnosis of SET of stomach such as gastrointestinal stromal tumor or leiomyoma was suspected, Laparoscopic surgery was performed for definite diagnosis and treatment of the huge SET of the stomach. Histologic diagnosis was ectopic HCC of the trabecular type. Its histologic grade was consistent with Edmondson grade II. Although ectopic HCC is quite rare tumor of the stomach, it should be considered in the differential diagnosis of other abdominal mass-like lesions. Currently, with advances of laparoscopic surgery, laparoscopic resection for complete excision of ectopic HCC is possible with acceptable results.

异位肝细胞癌（Ectopic hepatocellular carcinoma, HCC）可定义为起源于肝实质、却发生于肝外器官或组织的肝细胞癌。目前公开报道的异位肝病例不足100例，其中30例的异位组织中检出了肝细胞癌。本文报告1例酷似胃上皮下肿瘤（subepithelial tumor, SET）的异位肝细胞癌病例，该患者经腹腔镜切除术成功治愈，本病例报告同时附带相关文献综述。患者为61岁男性，因2个月来出现不明原因腹痛，于当地医疗中心行腹部计算机断层扫描（computed tomography, CT）时发现腹腔内肿块，遂转诊至我科诊疗。腹部磁共振成像（magnetic resonance imaging, MRI）及计算机断层扫描显示，胃旁左膈下间隙存在一枚直径7.2cm的不均质性肿块。食管胃十二指肠镜（Esophagogastroduodenoscopy）检查发现胃底处存在巨大上皮下肿块。结合上述检查结果，临床疑似为胃肠道间质瘤或平滑肌瘤这类胃部上皮下肿瘤。为明确该胃部巨大上皮下肿瘤的诊断并实施治疗，我们为患者实施了腹腔镜手术。术后组织病理学诊断为小梁型异位肝细胞癌，其组织学分级符合埃德森（Edmondson）分级Ⅱ级。尽管异位肝细胞癌是一种极为罕见的胃部肿瘤，但在对其他腹部占位性病变进行鉴别诊断时，仍需将其纳入考量范畴。当前随着腹腔镜手术技术的进步，通过腹腔镜切除术完整切除异位肝细胞癌已具备可行性，且可获得令人满意的治疗效果。