case_images: PMC10601708_01
case_images: Enhanced magnetic resonance imaging (a) and contrast-enhanced helical CT scan (b) at the portal venous phase of the abdomen showing a large, lobulating, contoured heterogeneous enhancing exophytic soft tissue mass, measuring 7.2 cm, over the subphrenic space adjacent to the stomach.
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case_images: F1
case_images: Abdominal enhanced magnetic resonance imaging and contrast-enhanced CT at the portal venous phase of the abdomen showed a 7.2-cm sized heterogenous enhancing exophytic mass over the left subphrenic space adjacent to the stomach (shown in Fig. 1a, b).
case_images: Gross specimen showed a soft and well-circumscribed tissue mass measuring 7.3 cm x 6.8 cm x 4.5 cm. There are linear stapling clip at the resecting surface from the stomach (arrow head) and Hem-o-lock ligating clip(R) at the feeding vessel (arrow).
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case_images: F2
case_images: Upon resection, the tumor was a gray or yellow-to-brown solid tumor contained within a thin fibrous capsule (shown in Fig. 2).
case_images: Microscopically, the tumor was composed of large polygonal cells arranged in a trabecular pattern separated by sinusoid-like blood spaces. a Tumor cells had enlarged and hyperchromatic nuclei with prominent nucleoli and abundant eosinophilic cytoplasm (H&E stain, x100). Immunohistochemical staining of the tumor showed capillarization of the sinusoidal vessels (CD34 stain, x100) (b), and strong and diffuse granular cytoplasmic staining (Hep Par 1 statin, x100) (c). The histologic diagnosis was ectopic HCC of the trabecular type. Its histologic grade was consistent with Edmondson grade II. Nuclei are enlarged and hyperchromatic.
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case_images: F3
case_images: Tumor cells had hyperchromatic nuclei with prominent nucleoli and abundant eosinophilic cytoplasm (shown in Fig. 3).
case_images: Timeline from symptoms to examinations, diagnosis, surgery, and follow-up test after discharge. LMC, local medical center; CT, computed tomography; MRI, magnetic resonance imaging; HCC, hepatocellular carcinoma; USG, ultrasonography; AFP, alpha-fetoprotein; PIVKA-II, protein induced by vitamin K absence or antagonist-II.
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case_images: F4
case_images: Timeline from symptoms to examinations, diagnosis, surgery, and follow-up test after discharge is shown in Figure 4.