Case Hepatic Endometriosis A Continuing Diagnostic Dilemma英文文献资料.docVIP

HindawiPublishingCorporation HPBSurgery Volume2009,ArticleID407206,4pages doi:10.1155/2009/407206 CaseReport CaseHepaticEndometriosis:AContinuingDiagnosticDilemma P.J.Goldsmith, N.Ahmad, D.Dasgupta, J.Campbell, J.A.Guthrie, andJ.P.A.Lodge 1 1 1 2 3 1 1 2 3 HepatobiliaryandTransplantUnit,StJames’sUniversityHospital,LeedsLS97TF,UK DepartmentofObstetricsandGynaecology,StJames’sUniversityHospital,LeedsLS97TF,UK DepartmentofRadiology,StJames’sUniversityHospital,LeedsLS97TF,UK CorrespondenceshouldbeaddressedtoJ.P.A.Lodge,peter.lodge@leedsth.nhs.uk Received19March2009;Accepted17May2009 RecommendedbyDanielJaeck Background. Intraparenchymal endometriosis of liver is rare. It may present as liver tumour and the diagnosis is not usually established till after surgery. Case Outline. A 48-year-old postmenopausal woman presented with right upper quadrant pain andacysticlivermass.Liverfunctiontestsandtumourmarkers(αFP,CEA,CA19-9,andCA125)werenormal.Radiological imaging (USS, CT and MRI) suggested a thick walled cystic mass involving segments IV and VIII with complex intracystic septations. Frozen section at operation suggested a benign cystadenoma. The cyst was enucleated using a CUSA (Cavitron ultrasonicaspirator).The?nalhistologycon?rmedendometriosis.Discussion.Elevencasesofhepaticendometriomahavebeen reportedandonlyfourinpostmenopausalwomen.Preoperativediagnosisposesachallengeandsofarnoneofthecaseshavebeen diagnosedpreoperatively.Surgeryremainsthetreatmentofchoice.Accuratediagnosisattimeofoperationmayavoidextensive liversurgeryanditsassociatedmorbidity. Copyright?2009P.J.Goldsmithetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. 1.Introduction lesion. The patient gave a one and a half year history of relapsingandremittingchronicrightupperquadrantpain requiring regular