title: Hepatic adenomatosis: a rare but important liver disease with severe clinical implications.
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.
authors.affiliation: 1 Department of Radiology, CIMED, La Plata, Buenos Aires, Argentina.
authors.forename: Maren
authors.initials: M
authors.lastname: Donato
authors.forename: Alireza
authors.initials: A
authors.lastname: Hamidian Jahromi
authors.forename: Ana Ines
authors.initials: AI
authors.lastname: Andrade
authors.forename: Roger
authors.initials: R
authors.lastname: Kim
authors.forename: Shabnum Ilyas
authors.initials: SI
authors.lastname: Chaudhery
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sangster
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000601:surgery*; D010533:Peritoneal Lavage; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Adenomatosis; Computed Tomography; Hemoperitoneum; Hemorrhage; Liver; Mass