{"paper_id":"a219630e-31d5-4ffe-be6d-ba8d21e651fe","body_text":"Abstract\nHepatic 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.\nReferences\nGiudice LC, Kao LC. Endometriosis. Lancet. 2004;364:1789–99.\nBergquist A. Extragenital endometriosis, a review. Eur J Sci. 1992;158:7–12.\nMarkham SM, Carpenter SE, Rock JA. Extrapelvic endometriosis. Obstet Gyncol Clin Am. 1989;16:193.\nMarchevsky AM, Zimmerman MJ, Aufses AH Jr, et al. Endometrial cyst of the pancreas. Gastroenterology. 1984;86:1589–91.\nGrabb A, Carr L, Goodman JD, et al. Hepatic endometrioma. J Clin Ultrasound. 1986;14:478–80.\nKhan AW, Craig M, Jarmulowicz M, Davidson BR. Liver tumours due to endometriosis and endometrial stromal sarcoma. HPB. 2002;4(1):43–5.\nSerdar E, Bulun MD. Endometriosis. N Engl J Med. 2009;360:268–79.\nSaleh N, Daw E. Endometriosis in non-gynecological sites. Practitioner. 1980;244:1189–95.\nSataloff DM, La Vorgna KA, McRarland MM. Extrapelvis endometriosis presenting as a hernia: clinical reports and review of the literature. Surgery. 1989;105:109–12.\nFinkel L, Marchevsky A, Cohen B. Endometrial cyst of the liver. Am J Gastroenterol. 1986;81:576–8.\nSampson JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of endometrial type. Boston Med Surg J. 1922;186:445–73.\nSampson JA. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obst Gynecol. 1927;14:442–69.\nMarik JJ. Endometriosis etiology. J Reprod Med. 1997;19:301–2.\nMalick JE. The etiology of endometriosis. J Am Osteopath Assoc. 1982;81:407.\nRidley JH. The histogenesis of endometriosis. Obstet Gynecol Surv. 1968;23:1.\nSuginami H. A reappraisal of the coelomic metaplasia theory by reviewing endometriosis occurring in unusual sites and instances. Am J Obstet Gynecol. 1991;165:214–8.\nFerguson BR, Bennington JL, Haker SL. Histochemistry of mucosubstances and histology of mixed mullerian pelvic lymph node glandular inclusions: evidence for histogenesis by mullerian metaplasia of coelomic epithelium. Obstet Gynecol. 1969;33:617.\nHarris HA, Bruner-Tran KL, Zhang X, Osteen KG, Lyttle CR. A selective estrogen receptor-beta agonist causes lesion regression in an experimentally induced model of endometriosis. Hum Reprod. 2005;20:936–41.\nConflict of interest\nThe authors declare that they have no conflicts of interest to report.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nRivkine, E., Jakubowicz, D., Marciano, L. et al. Hepatic endometrioma: a case report and review of the literature: report of a case. Surg Today 43, 1188–1193 (2013). https://doi.org/10.1007/s00595-012-0360-0\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00595-012-0360-0","source_license":"CC0","license_restricted":false}