title: Intrahepatic huge hematoma due to rupture of small hepatocellular adenoma: a case report.
abstract: Hepatocellular adenoma sometimes causes intraperitoneal hemorrhage. It is, however, rare for small hepatocellular adenoma to cause intrahepatic huge hemorrhage without intraperitoneal bleeding. Here we describe such a rare case of hepatocellular adenoma with huge intrahepatic hemorrhage in a 25-year-old female, who had taken oral contraceptives for the last 2 weeks. She was admitted to our hospital with a sudden onset of right-upper-quadrant abdominal pain and temporally fell in shock state. Plain CT depicted low density area measuring more than 13 cm in diameter in the right lobe of the liver. Huge tumor was also suggested by abdominal ultrasound, contrast enhanced CT, magnetic resonance imaging (MRI) and angiography. The patient was diagnosed as intrahepatic rupture of hepatic tumor. Because of the risk of re-hemorrhage and malignancy, she underwent right hepatic lobectomy. Histopathologial examination of the resected specimen showed a typical small hepatocellular adenoma with the surrounding huge hematoma in the liver. The case presented here is very rare but seems to be suggestive to the natural course and management of hepatocellular adenoma.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi 589-8511, Osaka-Sayama, Japan
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Hobyung
authors.initials: H
authors.lastname: Chung
authors.forename: Shigenaga
authors.initials: S
authors.lastname: Matsui
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitano
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Suetomi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Onda
authors.forename: Sadao
authors.initials: S
authors.lastname: Funai
authors.forename: Kenzou
authors.initials: K
authors.lastname: Kou
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yasutomi