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Hepatic and perihepatic involvement of female genital diseases and pregnancy: a review

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Abstract

The liver is rarely involved in female genital diseases or pregnancy. Peripheral hepatic and perihepatic lesions are mainly due to the progression of genital malignancies, usually ovarian cancer. It should be distinguished from other malignant and non-malignant lesions. In all clinical situations, liver involvement is a sign of distant extension or dissemination of female genital diseases. Therefore, accurate detection and characterization of hepatic and perihepatic involvement on imaging is of clinical importance and often changes patient management.

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References

  1. Nougaret S, Addley HC, Colombo PE, et al. (2012) Ovarian carcinomatosis: how the radiologist can help plan the surgical approach. Radiographics 32:1775–1800 (discussion 1800–1773)

    Article  PubMed  Google Scholar 

  2. Cormio G, Rossi C, Cazzolla A, et al. (2003) Distant metastases in ovarian carcinoma. Int J Gynecol Cancer 13:125–129

    CAS  PubMed  Google Scholar 

  3. Tirkes T, Sandrasegaran K, Patel AA, et al. (2012) Peritoneal and retroperitoneal anatomy and its relevance for cross-sectional imaging. Radiographics 32:437–451

    Article  PubMed  Google Scholar 

  4. Netter F (2014) Atlas of human anatomy, 6th edn. Saunders

  5. Kim S, Kim TU, Lee JW, et al. (2007) The perihepatic space: comprehensive anatomy and CT features of pathologic conditions. Radiographics 27:129–143

    Article  PubMed  Google Scholar 

  6. Raptopoulos V, Gourtsoyiannis N (2001) Peritoneal carcinomatosis. Eur Radiol 11:2195–2206

    CAS  PubMed  Google Scholar 

  7. Jemal A, Siegel R, Ward E, et al. (2009) Cancer statistics, 2009. CA 59:225–249

    PubMed  Google Scholar 

  8. Akin O, Sala E, Moskowitz CS, et al. (2008) Perihepatic metastases from ovarian cancer: sensitivity and specificity of CT for the detection of metastases with and those without liver parenchymal invasion. Radiology 248:511–517

    Article  PubMed  Google Scholar 

  9. Fujii S, Matsusue E, Kanasaki Y, et al. (2008) Detection of peritoneal dissemination in gynecological malignancy: evaluation by diffusion-weighted MR imaging. Eur Radiol 18:18–23

    PubMed  Google Scholar 

  10. Pannu HK, Bristow RE, Montz FJ, Fishman EK (2003) Multidetector CT of peritoneal carcinomatosis from ovarian cancer. Radiographics 23:687–701

    Article  PubMed  Google Scholar 

  11. Low RN (2007) MR imaging of the peritoneal spread of malignancy. Abdom Imaging 32:267–283

    PubMed  Google Scholar 

  12. Walkey MM, Friedman AC, Sohotra P, Radecki PD (1988) CT manifestations of peritoneal carcinomatosis. AJR Am J Roentgenol 150:1035–1041

    CAS  PubMed  Google Scholar 

  13. Agarwal A, Yeh BM, Breiman RS, Qayyum A, Coakley FV (2004) Peritoneal calcification: causes and distinguishing features on CT. AJR Am J Roentgenol 182:441–445

    PubMed  Google Scholar 

  14. Choi HJ, Lee JH, Kang S, et al. (2006) Contrast-enhanced CT for differentiation of ovarian metastasis from gastrointestinal tract cancer: stomach cancer versus colon cancer. AJR Am J Roentgenol 187:741–745

    PubMed  Google Scholar 

  15. Coakley FV, Choi PH, Gougoutas CA, et al. (2002) Peritoneal metastases: detection with spiral CT in patients with ovarian cancer. Radiology 223:495–499

    Article  PubMed  Google Scholar 

  16. Satoh Y, Ichikawa T, Motosugi U, et al. (2011) Diagnosis of peritoneal dissemination: comparison of 18F-FDG PET/CT, diffusion-weighted MRI, and contrast-enhanced MDCT. AJR Am J Roentgenol 196:447–453

    PubMed  Google Scholar 

  17. Bozkurt M, Doganay S, Kantarci M, et al. (2011) Comparison of peritoneal tumor imaging using conventional MR imaging and diffusion-weighted MR imaging with different b values. Eur J Radiol 80:224–228

    PubMed  Google Scholar 

  18. Low RN, Sebrechts CP, Barone RM, Muller W (2009) Diffusion-weighted MRI of peritoneal tumors: comparison with conventional MRI and surgical and histopathologic findings—a feasibility study. AJR Am J Roentgenol 193:461–470

    PubMed  Google Scholar 

  19. Funicelli L, Travaini LL, Landoni F, et al. (2010) Peritoneal carcinomatosis from ovarian cancer: the role of CT and [(1)(8)F]FDG-PET/CT. Abdom Imaging 35:701–707

    CAS  PubMed  Google Scholar 

  20. Gu P, Pan LL, Wu SQ, Sun L, Huang G (2009) CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and meta-analysis. Eur J Radiol 71:164–174

    PubMed  Google Scholar 

  21. Soussan M, Des Guetz G, Barrau V, et al. (2012) Comparison of FDG-PET/CT and MR with diffusion-weighted imaging for assessing peritoneal carcinomatosis from gastrointestinal malignancy. Eur Radiol 22:1479–1487

    PubMed  Google Scholar 

  22. Tempany CM, Zou KH, Silverman SG, et al. (2000) Staging of advanced ovarian cancer: comparison of imaging modalities—report from the Radiological Diagnostic Oncology Group. Radiology 215:761–767

    Article  CAS  PubMed  Google Scholar 

  23. Ricke J, Sehouli J, Hach C, et al. (2003) Prospective evaluation of contrast-enhanced MRI in the depiction of peritoneal spread in primary or recurrent ovarian cancer. Eur Radiol 13:943–949

    PubMed  Google Scholar 

  24. Moran BJ, Cecil TD (2003) The etiology, clinical presentation, and management of pseudomyxoma peritonei. Surg Oncol Clin N Am 12:585–603

    PubMed  Google Scholar 

  25. Bradley RF, Stewart JHt, Russell GB, Levine EA, Geisinger KR (2006) Pseudomyxoma peritonei of appendiceal origin: a clinicopathologic analysis of 101 patients uniformly treated at a single institution, with literature review. Am J Surg Pathol 30:551–559

    PubMed  Google Scholar 

  26. Ronnett BM, Zahn CM, Kurman RJ, et al. (1995) Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol 19:1390–1408

    CAS  PubMed  Google Scholar 

  27. Levy AD, Shaw JC, Sobin LH (2009) Secondary tumors and tumorlike lesions of the peritoneal cavity: imaging features with pathologic correlation. Radiographics 29:347–373

    Article  PubMed  Google Scholar 

  28. Tsai CJ (1998) Ultrasound features of disseminated adenomucinosis (pseudomyxoma). Br J Radiol 71:564–566

    CAS  PubMed  Google Scholar 

  29. Seshul MB, Coulam CM (1981) Pseudomyxoma peritonei: computed tomography and sonography. AJR Am J Roentgenol 136:803–806

    CAS  PubMed  Google Scholar 

  30. Yeh HC, Shafir MK, Slater G, et al. (1984) Ultrasonography and computed tomography in pseudomyxoma peritonei. Radiology 153:507–510

    Article  CAS  PubMed  Google Scholar 

  31. Sulkin TV, O’Neill H, Amin AI, Moran B (2002) CT in pseudomyxoma peritonei: a review of 17 cases. Clin Radiol 57:608–613

    CAS  PubMed  Google Scholar 

  32. Weigert F, Lindner P, Rohde U (1985) Computed tomography and magnetic resonance of pseudomyxoma peritonei. J Comput Assist Tomogr 9:1120–1122

    CAS  PubMed  Google Scholar 

  33. Miller DL, Udelsman R, Sugarbaker PH (1985) Calcification of pseudomyxoma peritonei following intraperitoneal chemotherapy: CT demonstration. J Comput Assist Tomogr 9:1123–1124

    CAS  PubMed  Google Scholar 

  34. Buy JN, Malbec L, Ghossain MA, Guinet C, Ecoiffier J (1989) Magnetic resonance imaging of pseudomyxoma peritonei. Eur J Radiol 9:115–118

    CAS  PubMed  Google Scholar 

  35. Graubard ZG, Koller AB (1987) Spontaneous rupture of a benign cystic teratoma. A case report. S Afr Med J 71:454–455

    CAS  PubMed  Google Scholar 

  36. Iwata A, Matsubara K, Umemoto Y, Hashimoto K, Fukaya T (2009) Spontaneous rupture of benign ovarian cystic teratoma in a premenarcheal girl. J Pediat Adolesc Gynecol 22:e121–e123

    Google Scholar 

  37. Pal DK, Kundu AK, Das S (1996) Spontaneous rupture of benign cystic teratoma. Trop Doct 26:190

    CAS  PubMed  Google Scholar 

  38. Payne-James JJ, Fitzgibbon E (1987) Spontaneous rupture of a benign cystic teratoma mimicking acute appendicitis. Br J Hosp Med 37:254

    CAS  PubMed  Google Scholar 

  39. Semchyshyn S (1977) Rupture of ovarian benign cystic teratoma causing acute abdomen. Can J Surg 20:282–283

    CAS  PubMed  Google Scholar 

  40. Shukunami K, Kubo M, Kaneshima M, Kotsuji F (2000) Postpartum spontaneous rupture of a benign cystic teratoma. J Obstet Gynaecol 20:443–444

    CAS  PubMed  Google Scholar 

  41. Fibus TF (2000) Intraperitoneal rupture of a benign cystic ovarian teratoma: findings at CT and MR imaging. AJR Am J Roentgenol 174:261–262

    CAS  PubMed  Google Scholar 

  42. Sinha R, Sundaram M, Lakhotia S (2009) Multiple intraabdominal parasitic cystic teratomas. J Minim Invasive Gynecol 16:789–791

    PubMed  Google Scholar 

  43. Gendre J, Sebban-Rozot C, Regent D, et al. (2011) Peritoneal parasitic teratoma and chemical dermoid peritonitis. J Radiol 92:382–392

    CAS  PubMed  Google Scholar 

  44. Huang HH, Tsai CM, Tyan YS (2011) Unusual cause should be kept in mind of abdominal pain in female patient. Fitz-Hugh–Curtis syndrome. Gastroenterology 140:e7–e8

    Article  PubMed  Google Scholar 

  45. Joo SH, Kim MJ, Lim JS, Kim JH, Kim KW (2007) CT diagnosis of Fitz-Hugh and Curtis syndrome: value of the arterial phase scan. Korean J Radiol 8:40–47

    PubMed Central  PubMed  Google Scholar 

  46. Tsubuku M, Hayashi S, Terahara A, Furukawa T, Ohmura G (2002) Fitz-Hugh–Curtis syndrome: linear contrast enhancement of the surface of the liver on CT. J Comput Assist Tomogr 26:456–458

    PubMed  Google Scholar 

  47. Pickhardt PJ, Fleishman MJ, Fisher AJ (2003) Fitz-Hugh–Curtis syndrome: multidetector CT findings of transient hepatic attenuation difference and gallbladder wall thickening. AJR Am J Roentgenol 180:1605–1606

    PubMed  Google Scholar 

  48. Takeshita T, Shima H, Oishi S, et al. (2004) Fitz-Hugh–Curtis syndrome: hepatic capsular enhancement and diffuse gallbladder wall thickening on contrast-enhanced CT. Intern Med 43:632–633

    PubMed  Google Scholar 

  49. Cho HJ, Kim HK, Suh JH, et al. (2008) Fitz-Hugh–Curtis syndrome: CT findings of three cases. Emerg Radiol 15:43–46

    PubMed  Google Scholar 

  50. Mesurolle B, Mignon F, Gagnon JH (2004) Fitz-Hugh–Curtis syndrome caused by Chlamydia trachomatis: atypical CT findings. AJR Am J Roentgenol 182:822–824 (author reply 824)

    PubMed  Google Scholar 

  51. Nishie A, Yoshimitsu K, Irie H, et al. (2003) Fitz-Hugh–Curtis syndrome. Radiologic manifestation. J Comput Assist Tomogr 27:786–791

    PubMed  Google Scholar 

  52. Romo LV, Clarke PD (1992) Fitz-Hugh–Curtis Syndrome: pelvic inflammatory disease with an unusual CT presentation. J Comput Assist Tomogr 16:832–833

    CAS  PubMed  Google Scholar 

  53. Acevedo F, Baudrand R, Letelier LM, Gaete P (2008) Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis 12:358–362

    PubMed  Google Scholar 

  54. Kanellopoulou T, Alexopoulou A, Tanouli MI, et al. (2010) Primary hepatic actinomycosis. Am J Med Sci 339:362–365

    PubMed  Google Scholar 

  55. Colette S, Donnez J (2009) Endometriosis. N Engl J Med 360:1911–1912 (author reply 1912)

    CAS  PubMed  Google Scholar 

  56. Giudice LC, Kao LC (2004) Endometriosis. Lancet 364:1789–1799

    PubMed  Google Scholar 

  57. Kalkur S, Raza A, Richardson RE (2013) Right upper quadrant pain? Think outside the liver: a case of diaphragmatic perihepatic endometriosis. J Obstet Gynaecol 33:743–744

    CAS  PubMed  Google Scholar 

  58. Abrao MS, Goncalves MO, Dias JA Jr, et al. (2007) Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 22:3092–3097

    PubMed  Google Scholar 

  59. Bazot M, Thomassin I, Hourani R, Cortez A, Darai E (2004) Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis. Ultrasound Obstet Gynecol 24:180–185

    CAS  PubMed  Google Scholar 

  60. Bazot M, Lafont C, Rouzier R, et al. (2009) Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis. Fertil Steril 92:1825–1833

    PubMed  Google Scholar 

  61. Weinfeld RM, Johnson SC, Lucas CE, Saksouk FA (1998) CT diagnosis of perihepatic endometriosis complicated by malignant transformation. Abdom Imaging 23:183–184

    CAS  PubMed  Google Scholar 

  62. Chamie LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC (2011) Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics 31:E77–E100

    Article  PubMed  Google Scholar 

  63. Ha HK, Lim YT, Kim HS, et al. (1994) Diagnosis of pelvic endometriosis: fat-suppressed T1-weighted vs conventional MR images. AJR Am J Roentgenol 163:127–131

    CAS  PubMed  Google Scholar 

  64. Sugimura K, Okizuka H, Imaoka I, et al. (1993) Pelvic endometriosis: detection and diagnosis with chemical shift MR imaging. Radiology 188:435–438

    Article  CAS  PubMed  Google Scholar 

  65. Ascher SM, Agrawal R, Bis KG, et al. (1995) Endometriosis: appearance and detection with conventional and contrast-enhanced fat-suppressed spin-echo techniques. J Magn Reson Imaging 5:251–257

    CAS  PubMed  Google Scholar 

  66. Fluegen G, Jankowiak F, Zacarias Foehrding L, et al. (2013) Intrahepatic endometriosis as differential diagnosis: case report and literature review. World J Gastroenterol 19:4818–4822

    PubMed Central  PubMed  Google Scholar 

  67. Ramia JM, De la Plaza R, Garcia I, et al. (2012) Liver metastasis of endometrial stromal sarcoma. World J Hepatol 4:415–418

    PubMed Central  PubMed  Google Scholar 

  68. Khan AW, Craig M, Jarmulowicz M, Davidson BR (2002) Liver tumours due to endometriosis and endometrial stromal sarcoma. HPB (Oxford) 4:43–45

    CAS  Google Scholar 

  69. Howlader N, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER cancer statistics review, 1975–2010, National Cancer Institute. Bethesda, MD based on November 2012 SEER data submission, posted to the SEER web site, April 2013. http://seer.cancer.gov/csr/1975_2010/. Accessed 10 Oct 2014

  70. Guth U, Huang DJ, Bauer G, et al. (2007) Metastatic patterns at autopsy in patients with ovarian carcinoma. Cancer 110:1272–1280

    Article  PubMed  Google Scholar 

  71. Alsolaiman MM, MacDermott RP, Bartholomew C (2002) Hepatic pseudocyst as the first presentation of squamous cell carcinoma of uterine cervix. Dig Dis Sci 47:2459–2462

    PubMed  Google Scholar 

  72. Nair A, Pai DR (2005) Single cystic liver metastasis in residual carcinoma of the uterine cervix. Eur J Obstet Gynecol Reprod Biol 122:126–127

    PubMed  Google Scholar 

  73. Estermann F, Thiebault S, Turnani C, et al. (1996) Pseudocystic metastases of carcinoma of the uterine cervix mimicking polycystic liver disease. Gastroenterol Clin Biol 20:1125–1128

    CAS  PubMed  Google Scholar 

  74. Gelfand MS, Hodgkiss T, Simmons BP (1989) Multiple hepatic abscesses caused by Streptococcus milleri in association with an intrauterine device. Rev Infect Dis 11:983–987

    CAS  PubMed  Google Scholar 

  75. Klare P, Buchmann E (1996) Multiple liver abscesses in long-term intrauterine device. Zentralblatt fur Gynakol 118:530–532

    CAS  Google Scholar 

  76. Barksdale J, Abolhoda A, Saremi F (2011) Intravenous leiomyomatosis presenting as acute Budd–Chiari syndrome. J Vasc Surg 54:860–863

    PubMed  Google Scholar 

  77. Fasih N, Prasad Shanbhogue AK, Macdonald DB, et al. (2008) Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 28:1931–1948

    Article  PubMed  Google Scholar 

  78. Weinstein L (1982) Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 142:159–167

    CAS  PubMed  Google Scholar 

  79. Rinehart BK, Terrone DA, Magann EF, et al. (1999) Preeclampsia-associated hepatic hemorrhage and rupture: mode of management related to maternal and perinatal outcome. Obstet Gynecol Survey 54:196–202

    CAS  Google Scholar 

  80. Heller MT, Tublin ME, Hosseinzadeh K, Fargiano A (2011) Imaging of hepatobiliary disorders complicating pregnancy. AJR Am J Roentgenol 197:W528–W536

    PubMed  Google Scholar 

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Acknowledgments

Authors would like to thank Dr Farhood Saremi for his help in the selection of images. They also would like to thank Fabrice Mauer and Typhaine Desperramons-Dutartre for their precious help in the production of the figures.

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None of the authors has any conflict of interest.

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Correspondence to Maxime Ronot.

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Beranger-Gibert, S., Lagadec, M., Boulay-Coletta, I. et al. Hepatic and perihepatic involvement of female genital diseases and pregnancy: a review. Abdom Imaging 40, 1331–1349 (2015). https://doi.org/10.1007/s00261-014-0263-1

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