Hepatic Endometriosis Mimicking Metastatic Disease: A Case Report and Review of the Literature

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This case report and literature review describe atypical imaging features of hepatic endometriosis mimicking metastatic neuroendocrine tumors, highlighting the diagnostic utility of core biopsy and immunohistochemistry for accurate identification.

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This case report describes a 61-year-old female whose hepatic endometriosis presented with atypical imaging features that closely mimicked metastatic neuroendocrine tumors. The diagnosis was confirmed through image-guided core biopsy and subsequent histologic and immunohistochemical analysis, which identified endometrial stromal proliferation within the liver tissue. The authors review existing literature to highlight specific imaging characteristics that may assist clinicians in distinguishing this rare condition from malignancy, noting that preoperative diagnosis remains challenging due to the lack of pathognomonic radiological signs. This paper is centrally about endometriosis — specifically focusing on the rare presentation of deep infiltrating endometriosis involving the liver parenchyma.

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Abstract

Endometriosis of the liver is an uncommon disease characterized by the presence of endometrial tissue in the liver. There are no pathognomonic radiological features for hepatic endometriosis and preoperative diagnosis is difficult by imaging. Most cases are diagnosed after surgery. We report atypical imaging features of hepatic endometriosis in a 61 year- old female that mimic metastatic disease to the liver. She was referred to our institution with a presumed diagnosis of metastatic neuroendocrine tumors to the liver. After imaging guided core biopsy and histologic and immunohistochemical analysis, the diagnosis of hepatic endometrial stromal proliferation was made. We review the literature and provide imaging features that may help in reaching the correct diagnosis of hepatic endometriosis.
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Hepatic Endometriosis Mimicking Metastatic Disease: A Case Report and Review of the Literature DOI: https://doi.org/10.3941/jrcr.v4i11.589Keywords: endometrioma, liverAbstract Endometriosis of the liver is an uncommon disease characterized by the presence of endometrial tissue in the liver. There are no pathognomonic radiological features for hepatic endometriosis and preoperative diagnosis is difficult by imaging. Most cases are diagnosed after surgery. We report atypical imaging features of hepatic endometriosis in a 61 year- old female that mimic metastatic disease to the liver. She was referred to our institution with a presumed diagnosis of metastatic neuroendocrine tumors to the liver. After imaging guided core biopsy and histologic and immunohistochemical analysis, the diagnosis of hepatic endometrial stromal proliferation was made. We review the literature and provide imaging features that may help in reaching the correct diagnosis of hepatic endometriosis. Downloads Published Issue Section License The publisher holds the copyright to the published articles and contents. However, the articles in this journal are open-access articles distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License, which permits reproduction and distribution, provided the original work is properly cited. The publisher and author have the right to use the text, images and other multimedia contents from the submitted work for further usage in affiliated programs. Commercial use and derivative works are not permitted, unless explicitly allowed by the publisher.

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