Metastatic hepatoma originating from the pons hepatis presenting extrahepatic growth: Classification of different patterns covering REX's recessus

A metastatic liver carcinoma which developed from the pons hepatis and presented as an extrahepatic mass on ultrasonography and computed tomography is reported. There have been no other reports of hepatoma documenting the extrahepatic growth developed from the pons hepatis. Herein we study the frequency of the pons hepatis and classify the form of REX's recessus. Of 125 cases that underwent upper abdominal operation, 46 cases (38%) had nothing under REX's recessus (Type I) 48 cases (37%) had a fibrous tissue under REX's recessus (Type II), and 31 cases (25%) had a pons hepatis (Type III). In type III, some cases suggested that the pons hepatis was ready to disconnect from side to side. We conclude that Type II is a mudified form of Type III, and Type I is a modified form of Type II.