Hepatic Uterus-Like Mass Misdiagnosed as Hepatic Abscess. (April 2015)

• Record Type: Journal Article
• Authors: Sopha, Sabrina C.; Rosado, Flavia G. N.; Smith, J. J.; Merchant, Nipun B.; Shi, Chanjuan
• Is Part Of: International journal of surgical pathology. Volume 23:Number 2(2015)
• Page Start: 134
• Page End: 139
• Publication Date: 2015-04
• Subjects: uterus-like mass -- endometriosis -- hepatic cyst; Pathology, Surgical -- Periodicals; 617.07
• DOI: 10.1177/1066896914534465
• Languages: English
• ISSNs: 1066-8969

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.