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Giant pedunculated hepatocellular carcinoma masquerading as a pelvic mass: a case report.

Jung HI - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: CT scan detected an approximately 15.0×13.4×11.4 cm-sized multilobulated homogeneous enhancing mass in the right adnexa.Operative findings showed that the pelvic mass originated from the liver.We performed hepatic wedge resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

ABSTRACT
Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, with high frequency rates in Asia. Many of the patients have unresectable disease at the time of diagnosis, and early detection and surgical resection is the best hope for survival. But, if HCC is presenting as an extrahepatic mass, the diagnosis is difficult. Herein, we report a case of primary HCC masquerading as a pelvic mass. A 74-year-old woman was admitted to our hospital due to a palpable mass in the lower abdomen. CT scan detected an approximately 15.0×13.4×11.4 cm-sized multilobulated homogeneous enhancing mass in the right adnexa. Operative findings showed that the pelvic mass originated from the liver. We performed hepatic wedge resection. Permanent histopathologic report revealed primary HCC. Exophytic-growing hepatocellular carcinoma should be carefully diagnosed.

No MeSH data available.


Related in: MedlinePlus

Operative findings showing a huge mass with a thin peduncle which was originated from the left lateral hepatic lobe (A and B).
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Figure 2: Operative findings showing a huge mass with a thin peduncle which was originated from the left lateral hepatic lobe (A and B).

Mentions: Hence, the initial impression was of a huge myoma uteri or right adnexal mass such as germ cell tumor (e.g. dysgerminoma, choriocarcinoma). Thus total abdominal hysterectomy with bilateral salpingo-oophorectomy was planned in the gynecologic department. During the operation, an exophytic mass with a thin peduncle originating from the left lateral hepatic lobe was observed. The mass was not infiltrating the uterus, the ovary and the other organs. Frozen-section biopsy was performed. The biopsy result was adenoma of uncertain origin, but carcinoma could not be excluded. Grossly, the tumor was fairly well-circumscribed and encapsulated. Remnant liver looked normal in color and consistency (Fig. 2). Therefore, we performed wedge resection of the hepatic mass leaving an adequate resection margin. She discharged on the tenth day after the operation without any complications. She was doing well for one year without adjuvant radiation and chemotherapy.


Giant pedunculated hepatocellular carcinoma masquerading as a pelvic mass: a case report.

Jung HI - Korean J Hepatobiliary Pancreat Surg (2014)

Operative findings showing a huge mass with a thin peduncle which was originated from the left lateral hepatic lobe (A and B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492317&req=5

Figure 2: Operative findings showing a huge mass with a thin peduncle which was originated from the left lateral hepatic lobe (A and B).
Mentions: Hence, the initial impression was of a huge myoma uteri or right adnexal mass such as germ cell tumor (e.g. dysgerminoma, choriocarcinoma). Thus total abdominal hysterectomy with bilateral salpingo-oophorectomy was planned in the gynecologic department. During the operation, an exophytic mass with a thin peduncle originating from the left lateral hepatic lobe was observed. The mass was not infiltrating the uterus, the ovary and the other organs. Frozen-section biopsy was performed. The biopsy result was adenoma of uncertain origin, but carcinoma could not be excluded. Grossly, the tumor was fairly well-circumscribed and encapsulated. Remnant liver looked normal in color and consistency (Fig. 2). Therefore, we performed wedge resection of the hepatic mass leaving an adequate resection margin. She discharged on the tenth day after the operation without any complications. She was doing well for one year without adjuvant radiation and chemotherapy.

Bottom Line: CT scan detected an approximately 15.0×13.4×11.4 cm-sized multilobulated homogeneous enhancing mass in the right adnexa.Operative findings showed that the pelvic mass originated from the liver.We performed hepatic wedge resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

ABSTRACT
Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, with high frequency rates in Asia. Many of the patients have unresectable disease at the time of diagnosis, and early detection and surgical resection is the best hope for survival. But, if HCC is presenting as an extrahepatic mass, the diagnosis is difficult. Herein, we report a case of primary HCC masquerading as a pelvic mass. A 74-year-old woman was admitted to our hospital due to a palpable mass in the lower abdomen. CT scan detected an approximately 15.0×13.4×11.4 cm-sized multilobulated homogeneous enhancing mass in the right adnexa. Operative findings showed that the pelvic mass originated from the liver. We performed hepatic wedge resection. Permanent histopathologic report revealed primary HCC. Exophytic-growing hepatocellular carcinoma should be carefully diagnosed.

No MeSH data available.


Related in: MedlinePlus