Hepatic uterus-like mass misdiagnosed as hepatic abscess.
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.


METHODS
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.


CONCLUSIONS
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.
The Johns Hopkins Hospital, Baltimore, MD, USA scsopha1@jhmi.edu.
Sabrina C
SC
Sopha
The Mayo Clinic, Rochester, MN, USA.
Flavia G N
FG
Rosado
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
J J
JJ
Smith
Vanderbilt University Medical Center, Nashville, TN, USA.
Nipun B
NB
Merchant
Vanderbilt University Medical Center, Nashville, TN, USA.
Chanjuan
C
Shi
D044963:Biopsy, Fine-Needle; D003951:Diagnostic Errors; D004715:Endometriosis / Q000175:diagnosis*; D005185:Fallopian Tube Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis*; D008107:Liver Diseases / Q000175:diagnosis*; D008875:Middle Aged; D013724:Teratoma / Q000150:complications; D014057:Tomography, X-Ray Computed
endometriosis; hepatic cyst; uterus-like mass