Gallbladder-associated symptomatic hepatic choristoma: Should you resect?

Area of Science:

• Hepatobiliary Surgery
• Surgical Pathology
• Embryology

Background:

• Hepatic choristomas (HC) are rare ectopic liver tissues resulting from embryological developmental failure.
• They can pose a risk of carcinogenesis, potentially transforming into hepatocellular carcinoma (HCC).
• Often asymptomatic, HC are typically discovered incidentally during abdominal surgery or autopsy.

Purpose of the Study:

• To report a case of symptomatic hepatic choristoma.
• To describe its preoperative detection and successful laparoscopic management.
• To underscore the importance of recognizing HC and its potential complications.

Main Methods:

• A 73-year-old female patient presented with biliary colic and a suspected gallbladder tumor.
• Preoperative imaging (ultrasound, CT scan) identified a lesion between the gallbladder and liver.
• Laparoscopic exploration revealed and enabled en-bloc resection of the hepatic choristoma during cholecystectomy.

Main Results:

• The hepatic choristoma was successfully removed laparoscopically with the gallbladder.
• Histopathological examination confirmed the absence of malignancy in the resected lesion.
• The patient's symptomatic presentation was addressed through surgical intervention.

Conclusions:

• Hepatic choristomas are rare and often incidentally found during abdominal surgeries.
• Awareness of HC and their potential for carcinogenesis is crucial for patient care.
• Surgical intervention is recommended for non-liver-attached choristomas due to HCC transformation risk.