CASE 172: HEPATIC ECTOPIC PREGNANCY, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman 24 yo, amenorrhea for 2 weeks, was suspected  in pregnancy, but ultrasound at pelvis showed uterus without gestational sac or mass beside uterus.

Ultrasound scan at liver detected one hyperechoic focal, hypovascular, round shape, size of 1.86 cm with fluid in central mass.

Blood test beta HCG is of 34k unit. Do you thing it is an ectopic pregnancy in liver and how to make sure the diagnosis for this case?.

MDCT with CE  was done  for  detection  the intrahepatic focal which was  near  the gall-bladder, size of  2cm, hypodense  cystic central and  blood supply by  hepatic artery (see 3 CT images).

ULTRASOUND AND MSCT LIVER SUGGESTED PRIMARY LIVER PREGNANCY WITH high value of beta HCG 32 k unit/ml. Methotrexate is drug of choice for treatment, after 2 weeks of injection of methotrexate the blood test beta HCG will be dropped to normal, the liver focal will get smaller as a cyst. This is a case of PLP (PRIMARY LIVER PREGNANCY) succesfully treated with METHOTREXATE. NO NEED of OPERATION. IT IS RESULT OF EARLY DIAGNOSTIC of PLP.

REFERENCE: Case in MEDIC of DATE 2008: Subhepatic Ectopic Pregnancy