Numerous small hepatic adenomas and hepatocellular carcinoma developed in a man after 11 years of methyl testosterone ingestion. The man presented with an acute surgical abdomen and a large filling defect in the liver. Laparotomy disclosed hemoperitoneum and a large hepatic hematoma. Focal hemorrhagic infarction in the excised right liver lobe involved both adenomas and normal parenchyma. Review of the English literature reveals no other case of both a benign and a malignant hepatocellular neoplasm associated with anabolic steroid therapy. Hemorrhagic benign liver tumor must be considered in the differential diagnosis in both female and male patients on hormone therapy who present with acute abdominal pain.