Case Report
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World J Gastroenterol. May 7, 2014; 20(17): 5147-5152
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5147
Intrathoracic caudate lobe of the liver: A case report and literature review
Ying-Yi Chen, Tsai-Wang Huang, Hung Chang, Hsian-He Hsu, Shih-Chun Lee
Ying-Yi Chen, Tsai-Wang Huang, Hung Chang, Shih-Chun Lee, Division of Thoracic Surgery, Department of Surgery, Taipei 114, Taiwan
Hsian-He Hsu, Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Author contributions: Chen YY and Huang TW contributed equally to this work; Lee SC designed this case report; Chen YY, Huang TW, Chang H and Hsu HH collected and analyzed the review data; and Chen YY and Huang TW wrote the paper.
Correspondence to: Shih-Chun Lee, MD, PhD, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, 325, Section 2, Cheng-Kung Road, Taipei 114, Taiwan. leesc001@yahoo.com.tw
Telephone: +886-2-87927167 Fax: +886-2-87927403
Received: November 1, 2013
Revised: February 9, 2014
Accepted: March 5, 2014
Published online: May 7, 2014
Processing time: 186 Days and 12.3 Hours
Abstract

Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are variable. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare, and only one case has previously been reported. It is difficult to make a correct diagnosis preoperatively. We presented a 53-year-old woman with complaints of an intermittent, productive cough and dyspnea for two months that was refractory to medical treatment. She had no previous history of trauma or surgery. A chest radiograph only showed a widening of the mediastinum. Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass, approximately 4.35 cm × 2.5 cm × 6.14 cm in size, protruding through the right diaphragmatic crura to the right pleural cavity, attached to the inferior vena cava, esophagus and liver. There was no conclusive diagnosis before surgery. After the operation, we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver, which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively. We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.

Keywords: Intrathoracic liver; Pulmonary sequestration; Supradiaphragmatic ectopic liver

Core tip: Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic liver have been reported in the literature. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare. It is difficult to make a correct diagnosis preoperatively. We reported the first case of a supradiaphragmatic heterotopic liver passing through the inferior vena cava foramen that coincidentally combined with intralobar pulmonary sequestration. We discussed the successful operation via a thoracic approach and reviewed the published literature.