Ectopic pregnancy in the liver incidentally diagnosed by imaging: A case report

Abstract

Abstract. The present report describes the case of a 31-year-old woman diagnosed with an ectopic pregnancy in the liver. The patient presented with amenorrhea for 40 days and abdominal distention for 27 days. A liver mass had been detected 6 days prior to presentation. Using ultrasound (US), a hyperechoic mass with a fluid sonolucent area was detected in the right hepatic lobe. Examination by computed tomography (CT) revealed the presence of a mass in the right hepatic lobe with a slightly low-density peripheral region and an oval central portion of lower density in the plain scan; the enhanced scan revealed a significantly enhanced peripheral region and a non-enhanced central portion.18 F-fluodeoxyglucose (FDG) positron emission tomography (PET)-CT showed a mass in the right hepatic lobe with an increased intake of FDG in the peripheral region (maximum standard uptake value, 5.7) and a non-increased intake of FDG in the central portion. The patient was then subjected to hysteroscopy and laparoscopy. Histopathologically, the mass was an ectopic pregnancy. The patient recovered following the surgery. In conclusion, a timely diagnosis of ectopic pregnancy was made for a 31-year-old women with an ectopic pregnancy in the liver on the basis of US, CT and PET-CT imaging results, which enabled surgery to be undertaken prior to any serious consequences. These observations may be helpful for the diagnosis of similar cases in the future.

An audit of the management of ectopic pregnancies in a district hospital, Gauteng, South Africa

“…Very rarely does it occur in the cervix, and less-reported sites are the ovaries and broad ligaments. 3 , 4 This abnormal localisation of pregnancy is a life-threatening obstetrical condition found in women of reproductive age, and it is a leading cause of maternal death when rupture occurs in the first trimester of pregnancy. 5 , 6 , 7 , 8 The aetiology of EP is not well understood, but risk factors associated with EP include pelvic inflammatory disease, puerperal sepsis, previous termination of pregnancy, post-abortion sepsis, appendicitis and use of intrauterine contraceptive devices.…”

Diagnostic utility of CT in differentiating between ruptured ovarian corpus luteal cyst and ruptured ectopic pregnancy with hemorrhage

“…It is one of the major complications encountered during the first trimester of pregnancy, and it has been reported that 1.3–2.4% of all pregnancies are ectopic pregnancies [ 6 ]. Most ectopic pregnancies occur in women in the age-group of 30–40 years and tubal pregnancy is the most common type of ectopic pregnancy [ 8 , 14 – 17 ]. Ectopic pregnancy may occur in the ovaries, abdominal cavity, broad ligament, and cervix; however, these are rare sites of ectopic pregnancy [ 7 , 18 ].…”

Primary hepatic pregnancy: report of a case treated with laparoscopic approach and review of the literature

“…The same technique with intravenous contrast enhancement showed a peripheral portion with a greatly increased density in the arterial phase and slightly increased density in the venous phase. A nonenhanced lower-density was evident in the central portion (9,21,29,33,40).…”

“…No history of pelvic inflammatory disease or uterine or tubal abnormalities at surgery were reported. An intrauterine contraceptive device was described to be in place in only two cases (40,42); in another case, the device had been removed before conception (4).…”

“…Abdominal tenderness, sickness, and hypovolemic shock occurring between 4 and 12 weeks of amenorrhea were reported as well (4, 6, 15, 18, 19, 21, 30, 33, 34). Fewer patients presented with nonspecific symptoms, such as epigastric pain, dyspepsia, or irregular vaginal bleeding, sometimes anticipating the acute clinical evolution (16,23,29,40,41).…”