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Abstract：
BACKGROUND: Hepatocellular carcinoma (HCC) in ectopic liver tissue is extremely rare.
METHODS: A 64-year-old woman presented initially with abdominal complaints. Computed tomography (CT) revealed a tumor in the diaphragm and laparoscopic resection of the tumor was performed. Histology showed HCC. During the next 4 years four more tumors, all of which showed HCC on histology and were located extrahepatically, was treated with laparoscopic resection. During this course the patient was followed with regular thoracoabdominal CT and measurement of serum alpha-fetoprotein (AFP). A negative magnetic resonance imaging (MRI) examination of the liver excluded a primary intrahepatic tumor.
CONCLUSIONS: The literature available on ectopic HCC and the guidelines for management of HCC do not address the postoperative surveillance of patients undergoing curative treatment. A follow-up regime has been proposed by Hatzaras et al. (2014) to include cross-sectional imaging of the liver and measurement of serum AFP levels [1]. CT would be the preferred study of choice in a total radiologic investigation of the abdomen. While MRI is prone to artifacts due to movements, CT scans allows so rapid recordings that this no longer is an issue. An early investigation of the liver for intrahepatic HCC should nevertheless be performed early to exclude primary intrahepatic HCC.
CONCLUSIONS: We recommend that patients with ectopic HCC should be followed every 6 months with measurement of AFP and abdominal CT imaging. MRI of the liver should be performed early to exclude primary intrahepatic HCC.
METHODS: A 64-year-old woman presented initially with abdominal complaints. Computed tomography (CT) revealed a tumor in the diaphragm and laparoscopic resection of the tumor was performed. Histology showed HCC. During the next 4 years four more tumors, all of which showed HCC on histology and were located extrahepatically, was treated with laparoscopic resection. During this course the patient was followed with regular thoracoabdominal CT and measurement of serum alpha-fetoprotein (AFP). A negative magnetic resonance imaging (MRI) examination of the liver excluded a primary intrahepatic tumor.
CONCLUSIONS: The literature available on ectopic HCC and the guidelines for management of HCC do not address the postoperative surveillance of patients undergoing curative treatment. A follow-up regime has been proposed by Hatzaras et al. (2014) to include cross-sectional imaging of the liver and measurement of serum AFP levels [1]. CT would be the preferred study of choice in a total radiologic investigation of the abdomen. While MRI is prone to artifacts due to movements, CT scans allows so rapid recordings that this no longer is an issue. An early investigation of the liver for intrahepatic HCC should nevertheless be performed early to exclude primary intrahepatic HCC.
CONCLUSIONS: We recommend that patients with ectopic HCC should be followed every 6 months with measurement of AFP and abdominal CT imaging. MRI of the liver should be performed early to exclude primary intrahepatic HCC.
摘要：
背景：异位肝组织中的肝细胞癌（HCC）极为罕见。
方法：一名64岁女性最初出现腹部不适。计算机断层扫描（CT）显示隔膜中有肿瘤，并进行了腹腔镜切除。组织学显示为HCC。在接下来的四年里，还有四个肿瘤，所有这些在组织学上都显示为HCC，并且位于肝外，采用腹腔镜切除术治疗。在此过程中，对患者进行定期胸腹CT检查并测量血清甲胎蛋白（AFP）。肝脏的负磁共振成像（MRI）检查排除了原发性肝内肿瘤。
结论：关于异位HCC和HCC管理指南的现有文献并未涉及接受治愈性治疗的患者的术后监测。Hatzaras等人提出了后续制度。（2014）包括肝脏的横断面成像和血清AFP水平的测量[1]。CT将是腹部全面放射学检查的首选研究。虽然MRI由于运动而容易出现伪影，CT扫描允许如此快速的记录，这不再是一个问题。然而，应尽早进行肝内HCC的肝脏早期调查，以排除原发性肝内HCC。
结论：我们建议异位HCC患者应每6个月随访一次AFP测量和腹部CT成像。应早期进行肝脏MRI以排除原发性肝内HCC。
方法：一名64岁女性最初出现腹部不适。计算机断层扫描（CT）显示隔膜中有肿瘤，并进行了腹腔镜切除。组织学显示为HCC。在接下来的四年里，还有四个肿瘤，所有这些在组织学上都显示为HCC，并且位于肝外，采用腹腔镜切除术治疗。在此过程中，对患者进行定期胸腹CT检查并测量血清甲胎蛋白（AFP）。肝脏的负磁共振成像（MRI）检查排除了原发性肝内肿瘤。
结论：关于异位HCC和HCC管理指南的现有文献并未涉及接受治愈性治疗的患者的术后监测。Hatzaras等人提出了后续制度。（2014）包括肝脏的横断面成像和血清AFP水平的测量[1]。CT将是腹部全面放射学检查的首选研究。虽然MRI由于运动而容易出现伪影，CT扫描允许如此快速的记录，这不再是一个问题。然而，应尽早进行肝内HCC的肝脏早期调查，以排除原发性肝内HCC。
结论：我们建议异位HCC患者应每6个月随访一次AFP测量和腹部CT成像。应早期进行肝脏MRI以排除原发性肝内HCC。
