S5715 A Rare Hepatic Mass Revealed as Intrahepatic Endometriosis

Neel Shah, Rahul Thakkar, Nathan Mielke
In: American Journal of Gastroenterology · 2025 · vol. 120(10S2) , pp. S19 · doi:10.14309/01.ajg.0001150320.55309.f3 · W7114800832
Case report OA: closed CC0
Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by qwen3.7-flash, 2026-10-03 ⓘ

A 54-year-old woman with prior ovarian endometriosis was diagnosed with rare intrahepatic endometriosis via biopsy after imaging revealed a hepatic mass mimicking neoplasm, highlighting the diagnostic challenge of this exceptionally rare condition.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-09-28 · read from full text ⓘ

This case report describes a 54-year-old woman with a history of ovarian endometriosis who presented with a hepatic mass incidentally discovered following a motor vehicle collision. Initial imaging suggested traumatic hematomas, but subsequent MRI findings of an enlarging complex lesion prompted a biopsy that revealed smooth muscle hyperplasia and epithelial proliferation. Immunohistochemical staining for PAX8, CK7, and estrogen receptor confirmed the diagnosis of intrahepatic endometriosis, distinguishing it from primary or metastatic malignancies. This paper is centrally about endometriosis — specifically the rare presentation of intrahepatic involvement mimicking hepatic neoplasms.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Introduction: Endometriosis is a chronic inflammatory disorder characterized by the presence of functional endometrial tissue outside the uterine cavity. Hepatic endometriosis is exceedingly rare and often mimics hepatic neoplasms on imaging. We present a unique case of intrahepatic endometriosis, incidentally discovered after a motor vehicle collision. Case Description/Methods: A 54-year-old woman with a history of laparoscopic resection of an ovarian endometrioma in 2017, class I obesity, and prior bariatric surgery was evaluated for a hepatic lesion incidentally discovered after a motor vehicle collision in 2022. Initial computed tomography (CT) imaging revealed a heterogeneous solid and cystic mass in the right hepatic lobe measuring 8.2 × 4.5 cm, along with a peritoneal nodule in the left anterior abdominal wall measuring up to 1.2 cm—both initially presumed to be traumatic hematomas. A follow-up MRI noted a 4 cm right hepatic lesion consistent with an intraparenchymal hematoma. After the patient obtained insurance coverage, a repeat MRI in March 2025 showed a complex right hepatic lesion measuring 8.9 × 8.0 cm with internal blood products and peripheral enhancement, as well as an enlarging anterior peritoneal nodule measuring 2.2 × 1.2 cm. Due to concern for malignancy, the patient underwent an ultrasound-guided liver biopsy. Histopathological analysis demonstrated hepatic parenchyma with smooth muscle hyperplasia, hemorrhage, and focal epithelial proliferation. Immunohistochemical staining was positive for PAX8, cytokeratin 7 (CK7), and estrogen receptor (ER), consistent with intrahepatic endometriosis. Discussion: Intrahepatic endometriosis is an exceptionally rare condition, with fewer than 30 cases reported worldwide. Its imaging appearance can mimic primary or metastatic hepatic tumors, making diagnosis challenging. This case highlights the importance of maintaining a broad differential in patients with atypical hepatic lesions, particularly those with a history of endometriosis, and underscores the critical role of histopathology and immunohistochemistry in establishing a definitive diagnosis.
Full text 2,142 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Introduction

Endometriosis is a chronic inflammatory disorder characterized by the presence of functional endometrial tissue outside the uterine cavity. Hepatic endometriosis is exceedingly rare and often mimics hepatic neoplasms on imaging. We present a unique case of intrahepatic endometriosis, incidentally discovered after a motor vehicle collision. Case Description/Methods: A 54-year-old woman with a history of laparoscopic resection of an ovarian endometrioma in 2017, class I obesity, and prior bariatric surgery was evaluated for a hepatic lesion incidentally discovered after a motor vehicle collision in 2022. Initial computed tomography (CT) imaging revealed a heterogeneous solid and cystic mass in the right hepatic lobe measuring 8.2 × 4.5 cm, along with a peritoneal nodule in the left anterior abdominal wall measuring up to 1.2 cm—both initially presumed to be traumatic hematomas. A follow-up MRI noted a 4 cm right hepatic lesion consistent with an intraparenchymal hematoma. After the patient obtained insurance coverage, a repeat MRI in March 2025 showed a complex right hepatic lesion measuring 8.9 × 8.0 cm with internal blood products and peripheral enhancement, as well as an enlarging anterior peritoneal nodule measuring 2.2 × 1.2 cm. Due to concern for malignancy, the patient underwent an ultrasound-guided liver biopsy. Histopathological analysis demonstrated hepatic parenchyma with smooth muscle hyperplasia, hemorrhage, and focal epithelial proliferation. Immunohistochemical staining was positive for PAX8, cytokeratin 7 (CK7), and estrogen receptor (ER), consistent with intrahepatic endometriosis.

Discussion

Intrahepatic endometriosis is an exceptionally rare condition, with fewer than 30 cases reported worldwide. Its imaging appearance can mimic primary or metastatic hepatic tumors, making diagnosis challenging. This case highlights the importance of maintaining a broad differential in patients with atypical hepatic lesions, particularly those with a history of endometriosis, and underscores the critical role of histopathology and immunohistochemistry in establishing a definitive diagnosis.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosisendometrioma

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. This is a recent paper (2025) — citers typically take a year or two to land, and the OpenAlex reference graph may still be filling in.

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK