Hepatocellular carcinoma fed by an aberrant posterior right hepatic artery

An aberrant hepatic artery arising from the dorsal pancreatic artery is extremely rare, although the arterial blood supply to the liver is variable. A 56-year-old Japanese man was admitted to our hospital with a lesion in the right hepatic lobe. Serum concentrations of alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9 were within the reference range. Abdominal arteriography showed a hypervascular lesion measuring 3.0 cm in diameter in the right hepatic lobe. The left hepatic artery, the middle hepatic artery, and the anterior branch of the right hepatic artery were derived from the common hepatic artery, while the posterior branch originated from the dorsal pancreatic artery. Computed tomography performed during arteriography via the common hepatic artery showed an arterial perfusion defect in the posterior segment of the right hepatic lobe and enhancement of the ventral portion of the tumor, while the dorsal portion was not enhanced. However, the dorsal portion of the tumor was enhanced when arteriography was performed via the dorsal pancreatic artery. A limited hepatic resection was performed. Histologically, the tumor was a moderately differentiated hepatocellular carcinoma with a thick trabecular pattern.