Eychenne Camille, Suc Bertrand, Delchier Marie C, Vidal Fabien, Rimailho Jacques, Illac Claire, Breibach Florence, Vaysse Charlotte, Chantalat Elodie
Department of Gynecological Surgery, CHU Rangueil, Toulouse, France.
Department of Visceral Surgery, CHU Rangueil, Toulouse, France.
J Obstet Gynaecol Res. 2019 Oct;45(10):2121-2127. doi: 10.1111/jog.14078. Epub 2019 Jul 31.
The localization of endometriotic disease in the hepatic pedicle has never been reported to date. We report the first case of a 67-year-old postmenopausal patient having presented an endometriotic lesion in the hepatic pedicle. A surgical biopsy was needed to confirm the diagnosis after a first radiologic biopsy that concluded the presence of a mucinous cystic tumor with low-grade dysplasia. Medical treatment with aromatase inhibitors was carried out because of the inextirpable nature of the lesion. The diagnosis and therapeutic management of this rarely occurring lesion of atypical localization in a postmenopausal patient is presented here. A review of the literature on this localization could have led to a damaging surgical treatment due to the different diagnoses suggested. Management of endometriosis relies on a multidisciplinary approach that each practitioner must know how to broach with patients of all ages.
肝蒂部子宫内膜异位症的定位迄今尚未见报道。我们报告首例67岁绝经后患者肝蒂部出现子宫内膜异位病变。首次放射学活检诊断为低级别发育异常的黏液性囊性肿瘤，之后需进行手术活检以确诊。由于病变无法切除，遂采用芳香化酶抑制剂进行药物治疗。本文介绍了这例绝经后患者罕见的非典型定位病变的诊断及治疗处理。鉴于文献中对此定位的不同诊断建议，若参考相关文献可能会导致有害的手术治疗。子宫内膜异位症的管理依赖多学科方法，每位从业者都必须知道如何与各年龄段的患者探讨这一问题。
