Hepatic uterus-like mass misdiagnosed as hepatic abscess

Sabrina C. Sopha, Flavia G N Rosado, J. J. Smith, Nipun Merchant, Chanjuan Shi

Research output: Contribution to journalArticle

10 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)134-139
Number of pages6
JournalInternational Journal of Surgical Pathology
Volume23
Issue number2
DOIs
StatePublished - Apr 19 2015
Externally publishedYes

Keywords

  • endometriosis
  • hepatic cyst
  • uterus-like mass

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

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