Agenesis of the Left Hepatic Lobe Undergoing Hepatectomy for Hepatocellular Carcinoma

Congenital agenesis of the left hepatic lobe is a rare anomaly, only 32 of which have been reported in Japan. We present here a case of left hepatic lobe agenesis accompanied with classical hepatocellular carcinoma (HCC). A 65-year-old man was referred to our hospital for further examination after mild dysfunction of liver was deteted in an annual medical checkup. He had neither hepatitis nor cirrhosis, and there were surgical histories of cholecystectomy 28 years previously and choledocholithotomy 10 years previously without hepatic resection. Abdominal CT revealed absence of the left hepatic lobe with caudate hypertrophy and a solitary hypervascular HCC occupying whole of the posterior segment of the right lobe. Transcatheteral arterial chemo-lipiodolization followed by posterior segmentectomy one month later were carried out successfully. This is apparently the first case of HCC with congenital agenesis of the left hepatic lobe undergoing curative resection.