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）可定义为起源于位于肝外器官或组织内的肝实质的肝细胞癌。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。本文作者报道1例表现为胃上皮下肿瘤（subepithelial tumor, SET）样表现的异位肝细胞癌病例，该患者经腹腔镜切除术（laparoscopic resection）成功治愈，本病例报告同时附带了相关的文献综述。一名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）时发现腹腔内占位性肿块，遂转诊至我科接受诊疗。腹部磁共振成像（magnetic resonance imaging, MRI）及CT检查结果显示，胃旁左膈下间隙存在一枚直径7.2cm的混杂密度肿块。食管胃十二指肠镜检查（Esophagogastroduodenoscopy）可见胃底部存在巨大上皮下肿块。结合上述检查结果，临床怀疑为胃上皮下肿瘤，如胃肠道间质瘤或平滑肌瘤。为明确诊断并治疗该胃巨大上皮下肿瘤，遂行腹腔镜手术。术后组织病理学诊断为小梁型异位肝细胞癌，组织学分级符合Edmondson II级。尽管异位肝细胞癌是一种极为罕见的胃部肿瘤，但在鉴别诊断其他腹部占位性病变时，应将其纳入考量范畴。当前随着腹腔镜手术技术的不断进步，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。