A 69-year-old woman underwent surgery for esophagogastric junction cancer. Multiple subcapsular nodules of several millimeters in size were identified on the liver surface and diagnosed as liver metastases based on pathological examination. Staging laparoscopy was performed after 2 courses of chemotherapy and the same nodules were detected, but the pathological diagnosis was biliary microhamartoma. Finally, the patient underwent curative surgery. In this case, thermal effects of the ultrasonic energy device with an inadequate resection margin in the initial partial hepatectomy was a major obstacle to pathological diagnosis. In addition, the primary lesion was a well differentiated tumor without severe atypia, which could increase the difficulty in pathological diagnosis. This rare entity should be listed as a differential diagnosis of small nodules of the liver, especially when coexisting with gastrointestinal cancers. This report suggests the importance of obtaining a sufficient amount of liver specimens without thermal artifacts, since such artifacts may cause inappropriate identification of structural and morphological findings of tissue components, leading to diagnostic pitfalls.
|Translated title of the contribution
|Biliary Microhamartoma in a Patient with Esophagogastric Junction Cancer That Resembled a Metastatic Liver Tumor and Significantly Influenced the Surgical Indication: Report of a Case
|Number of pages
|Japanese Journal of Gastroenterological Surgery
|Published - 2022
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