Hepatic adenoma: report of three cases and review of the literature.

Pathologically confirmed hepatic adenoma (HA) was observed in two women who were not using contraceptives and one 60-year-old man. All three cases had a mass in the right lobe of the liver and almost normal laboratory results. One case that had a movable pedunculated mass mimicked an extrahepatic tumor preoperatively, and two cases associated with acute abdominal pain resulting from intratumor hemorrhage were misdiagnosed as hepatoma and given interventional therapy prior to liver biopsy. In hepatic arterial DSA of two cases, the tumor appeared as hypervascular with peripheral blood supply and regularly parallel branches coursing centrally. On CT scans, the tumor appeared to be surrounded by a low-density ring in two cases, and an intratumor hyperdense area of fresh blood was noted in one case. Analysis of the three cases in this series and a review of the literature indicated that if the DSA and CT findings described above were revealed in a patient, particularly a young woman, with a mass of the right lobe of the liver (with or without acute abdominal pain) and normal laboratory results, HA should be strongly suspected, and CT-guided biopsy should be performed for pathological diagnosis, particularly when an equivocal diagnosis is made.