Scientific Letter
Review of published cases of hepatic choristoma. Differential diagnosis of umbilical cord masses
Revisión de casos publicados de coristoma hepático. Diagnóstico diferencial de masas de cordón umbilical
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Differential diagnosis of umbilical cord masses" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "132" "paginaFinal" => "134" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Y. González Ruiz, L. Cotaina Gracia, M. Ruiz de Temiño, A. Joana González Esgueda, M.R. Delgado Alvira" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Y." "apellidos" => "González Ruiz" "email" => array:1 [ 0 => "yuremagr@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Cotaina Gracia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Ruiz de Temiño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A. Joana" "apellidos" => "González Esgueda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "M.R." "apellidos" => "Delgado Alvira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Ginecología y Obstetricia, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Revisión de casos publicados de coristoma hepático. Diagnóstico diferencial de masas de cordón umbilical" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 951 "Ancho" => 975 "Tamanyo" => 165502 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transillumination of the wine-red mass in the umbilical cord.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a primigravida, 33 years of age, with no medical or surgical history of interest. Ultrasound examination at 28 weeks of gestation confirmed the presence of a 28<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>17<span class="elsevierStyleHsp" style=""></span>mm mass in the umbilical cord, with an umbilical cord diameter of 16<span class="elsevierStyleHsp" style=""></span>mm, and a small anechoic area with thin walls suggestive of hernial oedema.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient had a normal delivery at 40<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 weeks of gestation, giving birth to a girl that weighed 3290<span class="elsevierStyleHsp" style=""></span>g and had an Apgar score of 9/10.</p><p id="par0015" class="elsevierStylePara elsevierViewall">At birth, we observed an umbilical cord with a 4.5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.8<span class="elsevierStyleHsp" style=""></span>cm bulge protruding from its normal insertion site at the abdomen, lined with amniotic membrane through which could be seen a firm, wine-red mass located 1<span class="elsevierStyleHsp" style=""></span>cm away from the navel that was irreducible, with no accompanying symptoms (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Based on the examination findings, we considered the differential diagnosis of abdominal wall defect and umbilical cord mass.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The surgery involved the opening of the amniotic membrane in layers, revealing a solid mass in direct contact with the umbilical vein and with an intraperitoneal communication with the round ligament of the liver. The vascular structures and remnants of the umbilical cord were ligated, the mass fully resected, and the umbilical defect closed. There were no postoperative complications and the patient was discharged 5 days after the surgery.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The mass was submitted to the anatomical pathology department for investigation, and gross examination showed a well-defined brownish nodule measuring 2.5<span class="elsevierStyleHsp" style=""></span>cm, with a microgranular appearance upon sectioning that corresponded to hepatic tissue with preserved architecture at the histological level. The tissue surrounded a cyst-like structure consisting of gallbladder wall tissue that was compatible with a hepatobiliary choristoma.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Ectopic liver is a rare condition described as the presence of hepatic tissue outside the liver and with no hepatic connection.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The literature has reported the gallbladder as the most common location of ectopic liver, and it can also be found in the thorax, pancreas, spleen, hepatic ligaments, pylorus, greater omentum, oesophagus, gastric mucosa, adrenal cortex, retroperitoneum, pericardium, placenta and umbilical cord.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Several theories attempt to explain the appearance of ectopic liver in locations other than the gallbladder, such as the development of an accessory lobe that loses its connection with the main liver body, the migration of part of the <span class="elsevierStyleItalic">pars hepatica</span> to other sites where ectopic tissue then develops, or the trapping of hepatocytes by the adjacent mesenchyma during the formation of the liver sinusoids and their subsequent migration to more distant regions, such as the umbilical cord, while the connection with the main liver may be maintained through the umbilical vein.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The differential diagnosis of umbilical cord masses is complex and must include cyst and pseudocyst, haematoma, umbilical artery aneurysm, haemangioma, teratoma, angiomyomyxoma, patent urachus, ectopic liver, as well as the most common diseases of the umbilical cord, which are umbilical cord hernia, gastroschisis and omphalocoele.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Ectopic liver in the newborn is usually diagnosed by chance following imaging tests or surgical procedures performed for unrelated reasons. However, it may be diagnosed due to complications like torsion, which manifests with abdominal pain, gastric outlet obstruction and respiratory distress syndrome, caused by the presence of hepatic tissue in supradiaphragmatic locations.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Only eight other cases of hepatic tissue in the umbilical cord have been described in the literature<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2–6</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), and the diagnosis of the umbilical cord mass was made prenatally in three of the nine cases, with the definitive diagnosis being made by anatomical pathology. On rare occasions it can be accompanied by symptoms of infection and be associated with other abnormalities, such as utrachal or biliary atresia, ectopic pancreas and heart and lung malformations. In our case, as happened in the one described by Horn et al.,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> we observed an intraperitoneal connection with the liver that may correspond to the round ligament, a vestige of the left umbilical vein.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">To conclude, we would like to highlight that when ultrasound examination reveals a mass in the umbilical cord we should consider the possibility of rare conditions, like the one described here, along with more common diseases.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Doppler ultrasound of the mass can be helpful to this end, although as we mentioned above, in most cases the definitive diagnosis will be made postnatally. At any rate, the histological characteristics of the lesion should not change the obstetric approach in the absence of intestinal or vascular involvement in the foetus, and the surgical approach will depend on the suspected diagnosis after birth.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: González Ruiz Y, Cotaina Gracia L, Ruiz de Temiño M, González Esgueda AJ, Delgado Alvira MR. Revisión de casos publicados de coristoma hepático. Diagnóstico diferencial de masas de cordón umbilical. An Pediatr (Barc). 2015;83:132–134.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 951 "Ancho" => 975 "Tamanyo" => 165502 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transillumination of the wine-red mass in the umbilical cord.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">HMD, hyaline membrane disease; ND, not described; RDS, respiratory distress syndrome; RV, right ventricle; UC, umbilical cord; US, ultrasound.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Shaw and Pierog \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Park et al. \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Preminger et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Wax et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vaideeswar et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Go and Cho \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lee et al.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Horn et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Our case \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maternal age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delivery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Caesarean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Caesarean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vaginal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Suggestive manifestations \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RDS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RDS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gestational age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Weight (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1247 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3240 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2180 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3314 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2460 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3290 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sex \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prenatal diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19 week US: UC mass, 6.3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.5<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>7<span class="elsevierStyleHsp" style=""></span>mm, no blood flow \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32 seek US: hyperechoic mass on base of UC, 2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28 week US: UC mass, de 28<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>17<span class="elsevierStyleHsp" style=""></span>mm, UC diameter 16<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Attached to navel by a stalk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CU insertion site \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5<span class="elsevierStyleHsp" style=""></span>cm from the end of the UC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Proximal to UC and navel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.8<span class="elsevierStyleHsp" style=""></span>cm from UC insertion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Central at the navel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>cm from navel, proximal to UC \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Size \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>6<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.5<span class="elsevierStyleHsp" style=""></span>cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Very small \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.8<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.2<span class="elsevierStyleHsp" style=""></span>cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.8<span class="elsevierStyleHsp" style=""></span>cm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Colour \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Red-purple \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yellow-green, brown interior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Red \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dark red \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pale brown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Brown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yellowish grey \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Purplish brown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Wine red \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Consistency \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Firm, rubbery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Firm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Firm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Soft \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Firm, polyp-like \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Firm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Pathological anatomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal hepatic tissue \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Urachus cyst with immature hepatic tissue \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatic tissue with numerous portal areas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatic cords without bile ducts \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatocytes and fibrous connective tissue stroma, blood vessels and nerves \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatic tissue surrounded a small cyst-like structure corresponding to gallbladder wall tissue \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Peritoneal communication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Uncertain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes, with the round ligament of the liver \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Associated anomalies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliary atresia<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>ectopic pancreas in the jejunum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Atretic segment of the urachus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Double outlet RV <span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>right lung agenesis<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>HMD in left lung \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Absence of fourth toe in left foot \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab869307.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Literature review of published hepatic choristoma cases.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ectopic liver" "autores" => array:1 [ 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 12 | 16 |
| 2024 October | 42 | 38 | 80 |
| 2024 September | 46 | 40 | 86 |
| 2024 August | 58 | 68 | 126 |
| 2024 July | 48 | 31 | 79 |
| 2024 June | 39 | 28 | 67 |
| 2024 May | 43 | 50 | 93 |
| 2024 April | 45 | 30 | 75 |
| 2024 March | 42 | 33 | 75 |
| 2024 February | 35 | 36 | 71 |
| 2024 January | 25 | 21 | 46 |
| 2023 December | 22 | 22 | 44 |
| 2023 November | 26 | 26 | 52 |
| 2023 October | 25 | 31 | 56 |
| 2023 September | 41 | 23 | 64 |
| 2023 August | 31 | 19 | 50 |
| 2023 July | 30 | 33 | 63 |
| 2023 June | 27 | 22 | 49 |
| 2023 May | 33 | 18 | 51 |
| 2023 April | 15 | 31 | 46 |
| 2023 March | 34 | 21 | 55 |
| 2023 February | 38 | 20 | 58 |
| 2023 January | 16 | 37 | 53 |
| 2022 December | 35 | 24 | 59 |
| 2022 November | 42 | 30 | 72 |
| 2022 October | 36 | 41 | 77 |
| 2022 September | 19 | 35 | 54 |
| 2022 August | 28 | 49 | 77 |
| 2022 July | 25 | 37 | 62 |
| 2022 June | 22 | 34 | 56 |
| 2022 May | 22 | 37 | 59 |
| 2022 April | 25 | 29 | 54 |
| 2022 March | 36 | 59 | 95 |
| 2022 February | 25 | 32 | 57 |
| 2022 January | 25 | 41 | 66 |
| 2021 December | 18 | 42 | 60 |
| 2021 November | 35 | 52 | 87 |
| 2021 October | 55 | 56 | 111 |
| 2021 September | 38 | 48 | 86 |
| 2021 August | 36 | 38 | 74 |
| 2021 July | 29 | 38 | 67 |
| 2021 June | 44 | 55 | 99 |
| 2021 May | 26 | 35 | 61 |
| 2021 April | 83 | 58 | 141 |
| 2021 March | 51 | 34 | 85 |
| 2021 February | 25 | 16 | 41 |
| 2021 January | 35 | 18 | 53 |
| 2020 December | 32 | 24 | 56 |
| 2020 November | 15 | 17 | 32 |
| 2020 October | 24 | 13 | 37 |
| 2020 September | 16 | 20 | 36 |
| 2020 August | 26 | 20 | 46 |
| 2020 July | 23 | 25 | 48 |
| 2020 June | 26 | 13 | 39 |
| 2020 May | 37 | 26 | 63 |
| 2020 April | 39 | 16 | 55 |
| 2020 March | 32 | 21 | 53 |
| 2020 February | 24 | 12 | 36 |
| 2020 January | 26 | 16 | 42 |
| 2019 December | 52 | 22 | 74 |
| 2019 November | 18 | 17 | 35 |
| 2019 October | 34 | 28 | 62 |
| 2019 September | 29 | 14 | 43 |
| 2019 August | 40 | 19 | 59 |
| 2019 July | 32 | 22 | 54 |
| 2019 June | 24 | 23 | 47 |
| 2019 May | 127 | 20 | 147 |
| 2019 April | 81 | 25 | 106 |
| 2019 March | 41 | 19 | 60 |
| 2019 February | 43 | 17 | 60 |
| 2019 January | 34 | 17 | 51 |
| 2018 December | 45 | 28 | 73 |
| 2018 November | 89 | 47 | 136 |
| 2018 October | 123 | 26 | 149 |
| 2018 September | 40 | 12 | 52 |
| 2018 August | 14 | 0 | 14 |
| 2018 July | 5 | 0 | 5 |
| 2018 June | 14 | 0 | 14 |
| 2018 May | 12 | 0 | 12 |
| 2018 April | 42 | 0 | 42 |
| 2018 March | 33 | 0 | 33 |
| 2018 February | 22 | 0 | 22 |
| 2018 January | 115 | 0 | 115 |
| 2017 December | 57 | 0 | 57 |
| 2017 November | 30 | 0 | 30 |
| 2017 October | 21 | 0 | 21 |
| 2017 September | 19 | 0 | 19 |
| 2017 August | 16 | 0 | 16 |
| 2017 July | 15 | 1 | 16 |
| 2017 June | 29 | 8 | 37 |
| 2017 May | 22 | 2 | 24 |
| 2017 April | 18 | 4 | 22 |
| 2017 March | 15 | 28 | 43 |
| 2017 February | 24 | 3 | 27 |
| 2017 January | 10 | 3 | 13 |
| 2016 December | 25 | 5 | 30 |
| 2016 November | 40 | 9 | 49 |
| 2016 October | 56 | 8 | 64 |
| 2016 September | 46 | 6 | 52 |
| 2016 August | 28 | 4 | 32 |
| 2016 July | 18 | 4 | 22 |
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