A rare condition: Ectopic liver tissue with its unique blood supply encountered during laparoscopic cholecystectomy

Ahmet Bal; Sezgin Yilmaz; Betul Demirciler Yavas; Cigdem Ozdemir; Mustafa Ozsoy; Murat Akici; Mustafa Kalkan; Ogun Ersen; Baris Saripinar; Yuksel Arikan

doi:10.1016/j.ijscr.2015.02.027

A rare condition: Ectopic liver tissue with its unique blood supply encountered during laparoscopic cholecystectomy

Int J Surg Case Rep. 2015:9:47-50. doi: 10.1016/j.ijscr.2015.02.027. Epub 2015 Feb 20.

Authors

Affiliations

¹ Afyon Kocatepe University, The Faculty of Medicine, General Surgery Department, 03020 Afyon, Turkey.
² Afyon Kocatepe University, The Faculty of Medicine, General Surgery Department, 03020 Afyon, Turkey. Electronic address: drsezginyilmaz@gmail.com.
³ Afyon Kocatepe University, The Faculty of Medicine, Pathology Department, 03020 Afyon, Turkey.

Abstract

Introduction: Developmental abnormalities of liver including ectopic liver tissue (ELT) are rare conditions. Few cases presenting ELT have been reported in literature till now. Even though the most common area seen is gallbladder, it is detected both abdominal and thoracic sites. There is a relationship between HCC and ectopic liver that necessitates the removal.

Presentation of case: A 51-year-old female was hospitalized because of abdominal pain. Gallstone and bile duct dilatation were determined during ultrasonographic (USG) evaluation. The patient was operated for cholecystectomy following a successful endoscopic retrograde cholangiopancreatography (ERCP). During operation, a mass located on gallbladder with its unique vascular support was identified and resected together with gallbladder. The mass had a separate vascular stalk arising from liver parenchyma substance and it was clipped with laparoscopic staples. The histopathological examination revealed that the mass adherent to gallbladder was ectopic liver confirming the intraoperative observation. The postoperative course of patient was uneventfull and she was discharged at the second day after the operation.

Discussion: Ectopic liver tissue is incidentally found both in abdominal and thoracic cavity. ELT can rarely be diagnosed before surgical procedures or autopsies. It can be overlooked easily by radiological techniques. Although it does not usually produce any symptom clinically, it can rarely result in serious complications such as bleeding, pyloric and portal vein obstruction. ELT also has the capacity of malignant transformation to hepatocellular carcinoma that makes it essential to be removed.

Conclusion: Although ELT is rarely seen, it should be removed when recognized in order to prevent the complications and malignant transformation.

Keywords: Cholecystectomy; ERCP; Ectopic liver tissue; Gallbladder; Laparoscopy; Vascular supply.