Abstract

  Focal nodular hyperplasia (FNH), after hemangioma, is the second most common benign tumor of the liver. Rupture and hemorrhage in FNH is rare. To the best of our knowledge, only eight cases of rupture and hemorrhage in FNH have been reported in English literature. A 40-year-old woman presented acute onset of right upper quadrant pain. Ultrasonography of the abdomen demonstrated a large sub-capsular hematoma along the right side of the liver with non-homogenous mass with a diameter of10 cm. Abdominal CT scan with IV contrast revealed a huge sub-capsular hematoma in the posterior segment in the right lobe of the liver. The patient underwent surgery with presumptive diagnosis of hemorrhagic adenoma. During the operation, we noticed a nodular center in the resected liver mass. Pathologic examination revealed Focal Nodular Hyperplasia (classical type) in Right Liver lobe with extensive hemorrhage and necrosis. This is the first report of ruptures and hemorrhage in FNH in Iran which must be distinguished from liver adenoma.