Hepatic adenomatosis: a rare but important liver disease with severe clinical implications

Int Surg. 2015 May;100(5):903-7. doi: 10.9738/INTSURG-D-14-00161.1.


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.

Keywords: Adenomatosis; Computed Tomography; Hemoperitoneum; Hemorrhage; Liver; Mass.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / surgery*
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Hemoperitoneum / diagnostic imaging
  • Hemoperitoneum / surgery*
  • Hepatectomy
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / surgery*
  • Middle Aged
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / surgery*
  • Peritoneal Lavage
  • Tomography, X-Ray Computed


  • Contrast Media