Hepatic Uterus-Like Mass Misdiagnosed as Hepatic Abscess

Sopha SC, Sabrina C Sopha, Flavia G N Rosado, Flavia Rosado, Rosado FG, J. Joshua Smith, J J Smith, Merchant NB, Nipun B Merchant, Shi C, Chanjuan Shi
International journal of surgical pathology · 2014 · vol. 23(2) , pp. 134–139 · doi:10.1177/1066896914534465 · PMID:24827588 · W2063506085
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This case report details a 47-year-old woman's uterus-like mass in the liver, initially misdiagnosed as a hepatic abscess, highlighting the importance of considering hepatic endometriosis in differential diagnoses of refractory hepatic cysts.

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Abstract

BACKGROUND: Hepatic endometriosis/uterus-like mass is rare and may be overlooked during hepatic cyst workups. We report a case of uterus-like mass, misdiagnosed as hepatic abscess. CASE REPORT: A 47-year-old woman developed abdominal pain and vomiting. Infectious colitis with hepatic abscess was diagnosed, and remained antibiotic-refractory. Fine-needle aspiration and core biopsies showed benign contents. The patient presented to our institution with symptoms and normal blood work. Laparoscopic excision demonstrated a 1.4-cm cyst composed of endometrial glands (estrogen receptor+ and progesterone receptor+) and stroma (CD10+) with smooth muscle actin (SMA+), arranged in an organoid fashion. The patient, status-post hysterectomy, had no history or symptoms of endometriosis. CONCLUSION: This rare case illustrates the merit of considering uterus-like mass/endometriosis in the differential diagnosis of antibiotic-refractory hepatic cysts. Cyst heterogeneity may confound needle biopsy. We report the first instance of a hepatic uterus-like mass, with a review of related entities, postulated histogenesis, and important clinical associations.

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Condition tags

endometriosis

MeSH descriptors

Diagnostic Errors Endometriosis Liver Abscess Liver Diseases Biopsy, Fine-Needle Endometriosis Fallopian Tube Neoplasms Fallopian Tube Neoplasms Female Humans Liver Abscess Liver Diseases Middle Aged Teratoma Teratoma Tomography, X-Ray Computed

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