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Aggiornamento Liver Endometriosis

del 26-02-2013

World J Hepatol. 2012 Dec 27;4(12):415-8. doi: 10.4254/wjh.v4.i12.415.

Liver metastasis of endometrial stromal sarcoma.

Ramia JM, De la Plaza R, Garcia I, Perna C, Veguillas P, García-Parreño J.


Jose M Ramia, Roberto De la Plaza, Pilar Veguillas, Jorge García-Parreño, Department of Surgery, Hepatopancreatobiliary Surgical Unit, Hospital Universitario de Guadalajara, Guadalajara, 28020 Madrid, Spain.


Resection of liver metastases from gynaecological tumours is uncommon. Endometrial stromal sarcomas (ESS) are low incidence gynecological tumours which can originate in previous sites of endometriosis or following metaplasia of the pelvic peritoneal wall, and which are exceptionally associated with liver metastasis. We present a 68-year-old woman with a ESS and metachronic liver metastasis treated by liver resection. There is very little literature on clinical management about liver metastasis from ESS, but extrapolating the data obtained with liver metastasis from sarcomas and uterine tumours, we should recommend resection as this is considered a resectable extrauterine metastasis. In cases with more sites of extrauterine disease, liver resection should also be performed if the other sites are resectable.

Diagn Cytopathol. 2013 Jan 22. doi: 10.1002/dc.22945. [Epub ahead of print]

Hepatic endometriosis diagnosed by liquid-based cytology.

Hertel JD, Guimaraes M, Yang J.


The Department of Pathology, Medical University of South Carolina, Charleston, South Carolina.


A 44-year-old woman presented to Emergency Department with sudden onset of severe upper abdominal pain. T2-weighted MRI image showed a large cystic mass with a thickened wall measuring 9.5 × 9.1 × 11.2 cm in the right hepatic lobe. It was radiologically interpreted as a cystic mass with differential diagnosis including echinococcal cyst, biliary cystadenoma, and malignant neoplasm. The cystic mass was intraoperatively aspirated and a liquid-based cytology preparation (ThinPrep) and a cell block were made. The ThinPrep slides showed three dimensional clusters of epithelioid cells with scant delicate cytoplasm and tissue fragments composed of small stromal cells with round to oval shaped nuclei and a small amount of dense cytoplasm lined by the cuboidal epithelial cells. Occasional ciliated cells and abundant hemosiderin laden macrophages were also present. The cell block showed many tissue fragments containing glands and stroma with associated hemorrhage and hemosiderin laden macrophages, typical of endometrial tissue. Although it is uncommon, hepatic endometriosis should be considered in the differential diagnosis of cystic liver mass in women, especially those with a history of endometriosis or obstetric/gynecologic surgery. © 2013 Wiley Periodicals, Inc.

Surg Today. 2012 Oct 19. [Epub ahead of print]

Hepatic endometrioma: a case report and review of the literature: report of a case.

Rivkine E, Jakubowicz D, Marciano L, Polliand C, Poncelet C, Ziol M, Barrat C.


Department of Digestive and Endocrine Surgery, University Hospital Jean Verdier, Assistance Publique-Hôpitaux de Paris (AP-HP), Avenue du 14 Juillet, Bondy, 93140, Paris, France, emmanuel.rivkine@jvr.aphp.fr.


Hepatic endometriosis has an extremely rare occurrence characterized by the presence of ectopic endometrium in the liver. A diagnosis of hepatic endometriosis is established after surgery. A 51-year-old multiparous female was referred to our unit for investigation of a liver tumor. The patient reported a 6-month history of epigastric pain and vomiting. She had undergone conservative hysterectomy for uterine leiomyomas several years earlier. The results of liver function tests and the levels of tumor markers (CA 19.9, CEA, CA125, αFP) were normal. Radiological imaging (USS, CT and MRI) suggested the presence of liver cystadenoma, liver cystadenocarcinoma or cystic metastasis of the liver in the left liver lobe extending to the diaphragm with left hepatic vein compression. Laparotomy was performed. The intraoperative frozen sections suggested a diagnosis of endometriosis. Anatomical resection was performed, including left lobectomy with diaphragm resection. The final histology confirmed the presence of hepatic endometrioma without malignant transformation. Fourteen cases of hepatic endometrioma have been described in the medical literature. We herein report the 15th case. Making a preoperative diagnosis of hepatic endometriosis is very difficult, despite conducting a complete investigation, in the absence of clinical and radiological characteristics. The diagnosis is made according to a histological examination of the whole surgical sample.

Biochim Biophys Acta. 2013 Jan;1834(1):8-15. doi: 10.1016/j.bbapap.2012.10.004. Epub 2012 Oct 13.

Proteomics in reproductive biology: Beacon for unraveling the molecular complexities.

Upadhyay RD, Balasinor NH, Kumar AV, Sachdeva G, Parte P, Dumasia K.


Department of Neuroendocrinology, National Institute for Research in Reproductive Health, J.M. Street, Parel, Mumbai-400012, India. Electronic address: upadhyayrahul83@gmail.com.


Proteomics, an interface of rapidly evolving advances in physics and biology, is rapidly developing and expanding its potential applications to molecular and cellular biology. Application of proteomics tools has contributed towards identification of relevant protein biomarkers that can potentially change the strategies for early diagnosis and treatment of several diseases. The emergence of powerful mass spectrometry-based proteomics technique has added a new dimension to the field of medical research in liver, heart diseases and certain forms of cancer. Most proteomics tools are also being used to study physiological and pathological events related to reproductive biology. There have been attempts to generate the proteomes of testes, sperm, seminal fluid, epididymis, oocyte, and endometrium from reproductive disease patients. Here, we have reviewed proteomics based investigations in humans over the last decade, which focus on delineating the mechanism underlying various reproductive events such as spermatogenesis, oogenesis, endometriosis, polycystic ovary syndrome, embryo development. The challenge is to harness new technologies like 2-DE, DIGE, MALDI-MS, SELDI-MS, MUDPIT, LC-MS etc., to a greater extent to develop widely applicable clinical tools in understanding molecular aspects of reproduction both in health and disease.

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