Department of Surgery, Royal Free Hospital, London, UK.
HPB (Oxford). 2002;4(1):43-5. doi: 10.1080/136518202753598735.
Endometriosis can occur in unusual sites, liver involvement being first described in 1986. Extra-uterine malignant transformation in endometriosis has been reported, occurring mainly in the ovary. Liver involvement with endometrial stromal sarcoma (ESS) has not been previously reported.
Two patients presenting with symptomatic liver masses related to endometriosis, who successfully underwent surgical intervention, are presented.
CASE 1: A 31-year-old woman previously had been treated with hysterectomy and bilateral salpingoophorectomy for severe pelvic endometriosis. Six years later, she presented with malaise from bilobar liver involvement with endometrial deposits. She proceeded acutely to hilar obstruction with obstructive jaundice and portal vein thrombosis.
CASE 2: A 59-year-old post-menopausal woman had earlier presented acutely from a ruptured mesenteric cyst, which showed features of endometrial stromal sarcoma (ESS). Two years later, she presented with symptoms from a large ESS occupying the right lobe.
Endometriosis per se, as well as malignant transformation into ESS can involve the liver.These should be considered in women with hepatic space occupying lesions of unknown etiology.
子宫内膜异位症可发生在不常见的部位，1986 年首次描述了肝脏受累。子宫内膜异位症发生了卵巢外恶性转化。然而，子宫内膜间质肉瘤（ESS）在肝脏的受累尚未有报道。
我们呈现了两名患有与子宫内膜异位症相关的有症状肝肿块并成功接受手术干预的患者。
病例 1：一名 31 岁的女性，曾因严重的盆腔子宫内膜异位症接受了子宫切除术和双侧输卵管卵巢切除术。六年后，她因双侧肝内子宫内膜沉积物而出现全身不适。她迅速发展为肝门梗阻伴阻塞性黄疸和门静脉血栓形成。
病例 2：一名 59 岁绝经后妇女，曾因肠系膜囊肿破裂急性就诊，该囊肿表现为子宫内膜间质肉瘤（ESS）的特征。两年后，她因右叶大的 ESS 占位出现症状。
子宫内膜异位症本身以及恶性转化为 ESS 都可能累及肝脏。对于原因不明的肝占位性病变的女性，应考虑这些病变。
