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Case Report: Ectopic Liver (Choristoma) Discovered During Laparoscopic Cholecystectomy

Challenging differential diagnosis, Congenital defects / diseases

Leena H. Moshref, Abdulrahman M. Alotaibi

Saudi Arabia Department of Surgery, Doctor Soliman Fakeeh Hospital, Jeddah, Saudi Arabia

Am J Case Rep 2021; 22:e932784

DOI: 10.12659/AJCR.932784

Available online: 2021-07-13

Published: 2021-08-23


#932784

BACKGROUND: Ectopic liver (EL) is liver tissue that is not attached to the mother liver, and is also known as choristoma and hepar succenturiatum. According to Watanabe’s 1060-patient series, it has an incidence rate of less than 1% (0.47%). The absence of an anatomical attachment to the hepatic proper is a rare congenital departure from the norm, known as EL. EL is thought to be caused by abnormal hepatic tissue growth from the foregut diverticulum, particularly at cystic structures.
CASE REPORT: We report the successful management of a 47-year-old male patient, not known to have any medical illness, who was referred to the surgical team with a clinical picture of biliary colic. An ultrasound (US) abdomen was performed, and cholecystitis was confirmed. During a laparoscopic cholecystectomy, ET was identified by chance. He tolerated the operation well. Gallbladder histological examination revealed significant mucosal and wall ulcers, chronic inflammation, many black stones, no dysplasia or malignancy, and connected liver tissue measuring 12×5 mm. As a result, chronic calcular cholecystitis was confirmed, as was normal EL architecture and no evidence of malignancy.
CONCLUSIONS: We conclude that EL is a rare condition, but there have been cases reported in the literature. Imaging modalities such as US and computed tomography scans are recommended to rule out other underlying diagnoses and should be tailored to each individual when necessary. Because the presence of EL attached to the vesicle is a rare occurrence in the literature, a histological examination is required due to the elevated risk of hepatocellular carcinoma. Keeping such an abnormality in mind can help surgeons demarcate the embryological plane of dissection during cholecystitis to avoid tumor cell spillages if present.

Keywords: Cholecystectomy, Laparoscopic, Cholecystitis, Choristoma



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