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

Rivkine E, Emmanuel Rivkine, Déborah Jakubowicz, Léa Marciano, Marciano L, C. Polliand, Claude Polliand, Polliand C, Christophe Poncelet, C. Poncelet, Poncelet C, Marianne Ziol, Barrat C, Christophe Barrat
Surgery today · 2012 · vol. 43(10) , pp. 1188–1193 · doi:10.1007/s00595-012-0360-0 · PMID:23080414 · W2050520880
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

This case report describes the 15th documented instance of hepatic endometrioma, a rare condition where ectopic endometrium is found in the liver, typically diagnosed post-surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reports a rare case of hepatic endometriosis/endometrioma in a 51-year-old multiparous woman who presented with 6 months of epigastric pain and vomiting after a prior conservative hysterectomy for uterine leiomyomas. Despite normal liver function tests and tumor markers and imaging (USS/CT/MRI) suggesting benign or malignant liver cystic tumors, frozen section at laparotomy suggested endometriosis, and final histology confirmed hepatic endometrioma without malignant transformation, with surgical resection including left lobectomy and diaphragm resection. The authors note that preoperative diagnosis is very difficult in the absence of clinical and radiological characteristics and that diagnosis relies on histological examination of the whole surgical sample. This paper is centrally about endometriosis — it details a hepatic endometrioma case and reviews previously reported cases.

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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.
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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.

References

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Condition tags

endometriosisendometrioma

MeSH descriptors

Choristoma Endometriosis Endometriosis Endometrium Liver Diseases Liver Diseases Choristoma Choristoma Choristoma Diagnostic Imaging Diaphragm Diaphragm Endometriosis Endometriosis Female Hepatectomy Humans Laparotomy Liver Diseases Liver Diseases

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