Hepatocellular cancer arising from ectopic liver tissue on diaphragm. Case report

Ectopic liver tissue is a rare clinical entity; very few cases of extra peritoneal localization have been described in Literature.

A 54 years old male patient was admitted to our Institution because of thoraco - abdominal pain (lower left chest, left hypochondrium), and fever; CEA and CA 19-9 were in range, but alpha fetoprotein levels were high (880 IU / L); CT scan and NMR showed a thoraco - abdominal mass developing from the left hemidiaphragm, with infiltration of the cranial part of the spleen; no primitive liver tumors have been detected. A jejunal mesentery mass (6 cm in diameter) was also incidentally diagnosed.

The patient underwent surgical resection of the thoraco - abdominal tumor and of the mesenteric mass.

hepatocellular carcinoma arising from ectopic islet of liver tissue on left hemidiaphragm; mesenteric desmoid tumor.

The case we have observed showed a coexistence of two very rare tumors; carcinogenesis on ectopic liver should be suspected in this patient with a thoraco-abdominal mass with high alpha fetoprotein levels, in absence of primitive liver chronic diseases and cancer.