Ectopic hepatocellular carcinoma mimicking a retroperitoneal tumor: A case report

Figure 1 Imaging findings. A: Contrast-enhanced axial computed tomography (CT) scan in arterial phase and venous phase; B: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging scan in arterial phase and hepatobiliary phase showing a round and smoothly mass which located from the hepatic portal region of the liver to the dorsal of the pancreatic head (orange circle); C: Positron emission tomography-computed tomography revealed that the mass uptakes strongly (Standardized Uptake Value max: 13.8).

Figure 2 The microscopic examination of the tumor by endoscopic ultrasound-guided fine needle aspiration. Hematoxylin and eosin stain, magnification × 200 (left) and × 400 (right). Microscopic examination of the tumor confirmed poorly differentiated carcinoma.

Figure 3 The tumor is located at between the hepatic portal region and the dorsal of the pancreatic head and has no connection to the surrounding organ.

Figure 4 Macroscopic features of the excised hepatocellular carcinoma demonstrating a solid multinodular tumor with a fibrous capsule and intratumoral hemorrhage.

Figure 5 The microscopic examination of the tumor. Microscopic examination of the tumor confirmed poorly differentiated carcinoma morphologically similar to the tumor biopsy by endoscopic ultrasound-guided fine needle aspiration Hematoxylin and eosin stain, magnification × 100 (left) and × 400 (right).

Figure 6 Immunohistochemical findings. Tumor cells are negative for Hep Per-1, Glypican 3 and p53, but focal positive for Arginase-1. Moreover, CAM 5.2, AE1/AE3, and β-catenin are positive (Magnification × 400).