Introducere: Endometrioza hepatica (EH) este o provocare diagnosticã pentru clinicieni, din motivul numãrului foarte mic de cazuri
æi studierea insuficientã a problemei. Obiectiv. Cercetarea literaturii de specialitate æi evidenåierea particularitãåilor evoluåiei, a
caracteristicilor diagnostice æi gestionarea EH.
Materiale æi metode: Analiza surselor bibliografice æi datelor disponibile din PubMed æi Google Scholar utilizând termini MESH:
„endometriosis”, „liver”, „hepatic cyst”, „hepatic endometriosis”, „hepatic mass” cu identificarea a 44 de cazuri de EH raportat în
perioada aa. 1986-2020, în conformitate PRISMA.
Rezultate: Vârsta medie a pacientelor – 42.6±1.8 (21–73) ani. Simptomele mimeazã un spectru vast de patologii, cele mai frecvente:
durere intermitentã sau catamenialã în epigastru æi/sau flancul drept – 50% cazuri; icter vomã prelungitã, formaåiune palpabilã fãrã
alte manifestãri. În 4(9%) endometriomul hepatic a fost depistat incidental. Localizarea mai frecventã a lobului drept – 27(61.3%),
lobul stâng – 10(22.7%), bilobar – 4(9.1%), perihepatic – 1(2.3%), pediculul hepatic – 2(4.54%). Imagistica are o utilitate limitatã
în diagnosticul endometriozei, în special digestive, peritoneale sau hepatobiliare, deoarece nu are rezoluåie adecvatã pentru identificarea
implanturilor superficiale. Rezolvare chirurgicalã a fost aplicatã în 93.1%: excizia doar a leziunii fiind cea mai des aplicatã –
31.8%, urmatã de segmentectomii, hemihepatectomii, aspiraåia conåinutului. Este utilizatã pe larg terapia combinatã. Diagnosticul
confirmat morfologic prin prezenåa stromei æi glandele endometriale.
Concluzii: EH este o patologie orfanã, dificil de diagnosticat, cu simptome nespecifice æi limitãri imagistice. Trebuie consideratã un
diagnostic diferenåial la toate pacientele constatate cu o formaåiune la acest nivel, indiferent de vârstã.

Introduction: Hepatic endometriosis (HE) is a diagnostic challenge for clinicians, due to the very small number of cases and
insufficient study of the problem. Objective. Literature review and highlighting the peculiarities of evolution, diagnostic features and
management of HE.
Materials and methods: Analysis of bibliographic sources and data available from the PubMed and Google Scholar using MESH
terms: “endometriosis”, “liver”, “hepatic cyst”, “hepatic endometriosis”, “hepatic mass” with the identification of 44 cases of HE
reported during 1986-2020 period, according to PRISMA.
Results: The average age of the patients - 42.6±1.8 (21–73) years. Symptoms mimic a wide range of pathologies: intermittent or
catamenial pain in the epigastrium and/or right flank - 50% of cases; prolonged jaundice vomiting, palpable formation without other
manifestations. In 4(9%) hepatic endometrioma was detected incidentally. More frequent location: right lobe - 27(61.3%), left lobe
– 10(22.7%), bilobar - 4(9.1%), perihepatic - 1(2.3%), hepatic pedicle - 2(4.54%). Imaging investigations have limited utility in the
diagnosis of endometriosis, especially digestive, peritoneal or hepatobiliary, because it does not have adequate resolution to
identify superficial implants. Surgical management was widely applied - 93.1%: excision of the lesion was the most frequent –
31.8%, followed by segmentectomy, hemihepatectomy, aspiration. Combined therapy is widely used. Diagnosis was confirmed by
the presence of stroma and endometrial glands at histological examination. Conclusions. HE is an orphan pathology, difficult to
diagnose, with nonspecific symptoms and imaging limitations. A differential diagnosis should be considered in all patients found
with a formation at this level, regardless of age.