術前診断により待機的腹腔鏡下手術をし得た肝副葉茎捻転の一例

We report a rare case of a preoperatively diagnosed accessory liver lobe torsion that was treated with elective laparoscopic resection. A female in her 50s presented with epigastric pain. Imaging studies, including CT, MRI, and EUS, revealed a liver mass. Retrospective comparison with prior imaging revealed a similar lesion with normal density in the same region 1 year earlier. EUS revealed a liver-like vascular architecture, and color Doppler demonstrated no significant blood flow. FDG-PET revealed peripheral uptake without central accumulation. These findings suggested an accessory liver lobe torsion rather than a malignancy. Elective laparoscopic resection was performed, and histopathology confirmed infarcted liver tissue without evidence of malignancy. This case underscores the significance of comparative imaging and cautious evaluation of multimodal diagnostic studies in differentiating rare causes of acute abdominal pain from hepatic neoplasms.