Heterotopic liver in the umbilicus: A case report

Umbilical masses are very rare a clinical presentation in neonates. We report here a case of heterotopic liver within the umbilicus of an 18 day-old newborn. The baby was born in 38 weeks and 2 days' gestation, and weighed 3.0 kg at birth, who presented with a congenital protruding umbilical mass, measuring 1.8 cm in greatest dimension. Abdominal ultrasonography found no connection with the visceral organ. The histology of the lesion consisted with epithelial cells organized into plates or cords separated by thin vascular channels. The component cells were polygonal in shape and contained eosinophilic cytoplasm with round and prominent nucleoli, which were morphologically consistent with hepatocytes. They were positive for hepatocyte-antigen and cytokeratin-18. A review of literature revealed six other heterotopic liver in umbilicus. The six previous cases measured from 2 cm to 7.5 cm, and thus the present case is the smallest one. Of the six previous cases, four had clinical symptoms such as intrauterine death, infection, obstruction of the bile ducts. Our case and the other two previous cases had no associated symptoms, which means heterotopic liver in umbilicus can present only as mass itself without accompanying any clinical symptoms. To the best of our knowledge, this is the seventh reported case of ectopic liver in the umbilicus in the literature.