Hepatic endometrioma: a case report and review of the literature: report of a case

Abstract

Hepatic endometriosis has an extremely rare occurrence characterized by the presence of ectopic endometrium in the liver. A diagnosis of hepatic endometriosis is established after surgery. A 51-year-old multiparous female was referred to our unit for investigation of a liver tumor. The patient reported a 6-month history of epigastric pain and vomiting. She had undergone conservative hysterectomy for uterine leiomyomas several years earlier. The results of liver function tests and the levels of tumor markers (CA 19.9, CEA, CA125, αFP) were normal. Radiological imaging (USS, CT and MRI) suggested the presence of liver cystadenoma, liver cystadenocarcinoma or cystic metastasis of the liver in the left liver lobe extending to the diaphragm with left hepatic vein compression. Laparotomy was performed. The intraoperative frozen sections suggested a diagnosis of endometriosis. Anatomical resection was performed, including left lobectomy with diaphragm resection. The final histology confirmed the presence of hepatic endometrioma without malignant transformation. Fourteen cases of hepatic endometrioma have been described in the medical literature. We herein report the 15th case. Making a preoperative diagnosis of hepatic endometriosis is very difficult, despite conducting a complete investigation, in the absence of clinical and radiological characteristics. The diagnosis is made according to a histological examination of the whole surgical sample.

Hepatic pedicle endometriosis: Case report and review of the literature

“…One can also mention the diffusion of endometriotic cells by the lymphatic system, since the final anatomopathologic results show an endometrial‐like inclusion within the six hilar lymph nodes sampled as well as in a periportal lymph node. The 22 cases of hepatic endometriosis described in the literature concern the hepatic parenchyma . The most frequent type of case is that of a hepatic cystic lesion revealed during imaging exploration conducted on a background of pain.…”

“…It may however, develop in most organs with 21% involving the digestive system, more specifically the rectum and the rectosigmoid junction. Hepatic endometriosis, still a rare localization, has been reported in 22 cases, most often in the form of endometriotic cysts in the hepatic or pericapsular parenchyma . We describe here the first case of an endometriotic lesion developed within the hepatic pedicle in a postmenopausal patient with no known history of pelvic endometriosis.…”

“…Hepatic endometriosis, still a rare localization, has been reported in 22 cases, most often in the form of endometriotic cysts in the hepatic or pericapsular parenchyma. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] We describe here the first case of an endometriotic lesion developed within the hepatic pedicle in a postmenopausal patient with no known history of pelvic endometriosis. We discuss the still unknown aspects of this pathology that should nevertheless be mentioned among differential diagnoses when a hepatic or perihepatic lesion is found.…”

Fairly rare clear cell adenocarcinoma mimicking liver cancer: a case report

“…Clear cell carcinoma is characterized by clear cells containing glycogen arranged in tubular, papillary, and solid patterns, which commonly occurs in the ovary and kidney [ 1 , 2 ]. On the other hand, clear cell cholangiocarcinoma was rarely reported [ 5 ].…”

“…Clear cell carcinoma is generally thought to originate from ovary and kidney [ 1 ]. Clear cell carcinoma of the ovary is composed of glycogen-containing clear cells and hobnail cells [ 1 , 2 ]. Clear cell carcinoma of the ovary also shares many similarities with renal clear cell carcinoma [ 3 ].…”