Focal liver lesion secondary to endometriosis: case report and literature review

Introduction: Hepatic endometriosis is a rare disorder, without preoperative imaging findings are unclear. A diagnosis of endometriosis in a heterogeneous cystic liver mass should be considered, especially in patients with known endometriosis. Case report: A 40-year-old female patient complaining of sporadic abdominal and pelvic pain, not related to the menstrual cycle and without previous history of endometriosis, underwent routine sonographic evaluation, which indicated a lesion in the right hepatic lobe, apparently solid-cystic to ultrasonography. Upon further investigation using computed tomography (CT) and magnetic resonance imaging (MRI), image patterns consistent with hemorrhagic spots were also found; however, without the characteristics compatible with the most common focal hepatic lesions. It was suggested a possible diagnosis of metastasis by tumor of unknown site, due to the presence of a heterogeneous and hypodense nodule in the paracolic gutter, right to the CT, and then established the correlation with the clinical condition. The histological analysis has found a liver endometriosis, and the patient was referred surgical treatment. Conclusions: Based on the analysis of this case, the authors present a review of the cases of liver endometriosis described so far, exposing and comparing the most common clinical and image findings.