J Korean Soc Radiol.  2020 Jan;81(1):197-202. 10.3348/jksr.2020.81.1.197.

Extrauterine Adenomyoma of the Liver Mimicking a Hepatic Adenoma: A Case Report

• Won YJ
• Woo JY
• Byun J
• Hong ME

• KMID: 2469193
• DOI: http://doi.org/10.3348/jksr.2020.81.1.197

Abstract

Extrauterine adenomyoma of the liver is extremely rare. Only a few cases have been reported, and these reports have focused mainly on histopathology. Herein, we report the specific imaging findings of extrauterine adenomyoma of the liver in a 43-year-old woman with epigastric pain, which was initially diagnosed as a hepatic adenoma. CT and MRI revealed a solid and cystic mass with hemorrhagic foci and weak persistent enhancement, located in the subcapsular region of the right hepatic lobe.

MeSH Terms

Adenoma*
Adenoma, Liver Cell
Adenomyoma*
Adult
Female
Humans
Liver*
Magnetic Resonance Imaging
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Extrauterine adenomyoma of the liver in a 43-year-old woman. A. Axial contrast-enhanced CT reveals a 3 × 2 × 2 cm bilobed mass in the subcapsular area of segment VI of the liver. The medial lobe of the mass exhibits low-density without enhancement (white arrows), and the lateral lobe exhibits an enhanced solid portion with peripheral lowdensity dots (black arrows). The enhancement pattern is subtle in arterial phase, with persistent enhancement in the portal and delayed phases without washout. B. Axial and coronal T2-weighted images exhibit high-signal intensities in the medial lobe and periphery of the lateral lobe of the bilobed mass, indicating a cystic component. There is focal high-signal intensity within the medial cystic portion on the in-phase and out-of-phase axial T1-weighted images, suggesting a hemorrhagic component (arrows). The solid portion of the lateral lobe of the mass exhibits slight high-signal intensity on T2-weighted images, and a subtle low-signal intensity on T1-weighted images. It also exhibits mild heterogeneous enhancement in the arterial phase and weak persistent enhancement in the portal and delayed phases. C. Photograph depicting the gross appearance of the mass shows well defined, bilobed, whitish, and solid mass with multiple cysts filled with dense brown fluid (arrows). D. Microscopically, the mass is composed of thick muscular tissue (asterisk) lined with benign endometrial gland (white arrow) and stroma (black arrow) that resembles uterine endometrium (H&E). ER and PR immunohistochemical stains are suggestive of endometrioid glands. The endometrioid stromas are positive for CD10. The smooth muscle component is positive for SMA. ER = estrogen receptor, H&E = hematoxylin and eosin stain, PR = progesterone receptor, SMA = smooth muscle actin

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