Ectopic hepatocellular carcinoma manifesting multiple abdominal masses

Rationale: Ectopic hepatocellular carcinoma (HCC) is a rare disease that mostly originates from an ectopic liver. Patient concerns: The patient was admitted with upper abdominal distention for 3 months, which aggravated after meal. Diagnoses: A contrast-enhanced computed tomography (CT) scan revealed multiple abdominal masses. After exploratory laparotomy and histological examination, the patient was diagnosed as ectopic HCC. Interventions: Exploratory laparotomy was performed for the purpose of diagnosis and treatment. Outcomes: The tumors were excised by surgery and his symptom of upper abdominal distention was disappeared. A second surgery was performed for tumor recurrence and the patient died with total survival time of 22 months. Lessons: Ectopic HCC was usually in clinically silent, unless compression symptoms or intra-abdominal bleeding appeared. It did not have any typical character features in CT or Magnetic resonance imaging, may present with multiple abdominal masses. Surgery resection seems to be one of the effective treatments for ectopic HCC, though it is detected with multiple tumors. Abbreviations: AFP = serum alpha-fetoprotein, CA-125 = carbohydrate antigen 125, CEA = carcinoembryonic antigen, CK = cytokine, CT = computed tomography, DSA = digital subtraction angiography, HAC = hepatoid adenocarcinoma, HBs Ab = hepatitis B virus surface antibody, HBs Ag = Hepatitis B virus surface antigen, HCC = hepatocellular carcinoma, HCV Ab = hepatitis C virus antibody, MRI = magnetic resonance imaging.