Hepatic Adenomatosis: A Rare but Important Liver Disease With Severe Clinical Implications

Author:

Donato Maren1,Jahromi Alireza Hamidian2,Andrade Ana Ines1,Kim Roger2,Chaudhery Shabnum Ilyas3,Sangster Guillermo4

Affiliation:

1. Department of Radiology, CIMED, La Plata, Buenos Aires, Argentina

2. Department of Surgery,

3. Department of Pathology, and

4. Department of Radiology, LSU Health-Shreveport, Shreveport, Louisiana, USA

Abstract

A 56-year-old white female presented to the emergency room (ER) with acute onset of right upper quadrant abdominal pain, nausea, and vomiting, and she was found to have a sudden drop in hemoglobin. Abdominal computed tomography (CT) with and without intravenous contrast revealed multiple bilobar focal hepatic hypervascular lesions, one of them demonstrating spontaneous rupture with active intraperitoneal bleeding. A moderate hemoperitoneum was present. The patient underwent exploratory laparotomy for right hepatic posterior segmentectomy (right posterior sectionectomy) and peritoneal lavage. The histopathology evaluation revealed multiple liver adenomas. Hepatic adenomatosis is a clinical entity characterized by 10 or more hepatic adenomas. It must be distinguished from isolated hepatic adenoma as it bears a much higher risk of complications, such as spontaneous rupture, hemorrhage and malignant transformation. Here we discuss the radiologic and histopathologic findings of the current case along with a review of the English language medical literature.

Publisher

International College of Surgeons

Subject

Surgery

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