Case hepatic endometriosis: a continuing diagnostic dilemma

Area of Science:

• Hepatology
• Surgical Pathology
• Gastroenterology

Background:

• Intraparenchymal liver endometriosis is an exceedingly rare condition.
• It frequently presents as a liver tumor, complicating preoperative diagnosis.
• Diagnosis is typically confirmed only after surgical intervention.

Observation:

• A 48-year-old postmenopausal woman presented with right upper quadrant pain and a cystic liver mass.
• Radiological imaging revealed a complex cystic mass in liver segments IV and VIII.
• Intraoperative frozen section suggested a benign cystadenoma, with final histology confirming endometriosis.

Findings:

• This report adds to the limited literature on hepatic endometrioma, with only eleven cases documented.
• The case is notable as it involves a postmenopausal woman, a demographic with few reported instances.
• Preoperative diagnosis remains a significant challenge, with no reported cases diagnosed prior to surgery.

Implications:

• Accurate intraoperative diagnosis can prevent unnecessary extensive liver resections.
• Surgical enucleation is the established treatment for hepatic endometriosis.
• Further research may improve preoperative diagnostic accuracy for this rare entity.