Abstract
A 54-year-old woman was referred to our hospital for further examination of a hepatic mass detected on abdominal US. The blood test revealed a positive but mild inflammatory response. Hepatic virus markers were negative. Abdominal CT showed a fatty mass, 10 cm in diameter, in segments 7 and 8, containing hypervascular nodules showing early enhancement in the arterial phase and washout in the equilibrium phase. She presented with a high fever of over 39°C during a work-up period, and the blood test revealed a marked inflammatory response. Abdominal CT and MRI after developing fever indicated intratumoral hemorrhage. There was no other evidence of infection. We suspected hepatocellular carcinoma with intratumoral hemorrhage based on these imaging findings. Although we considered other benign tumors in the differential diagnosis, she underwent right hepatectomy because the tumor was symptomatic. Histologically, the tumor was composed of smooth muscle cells, vessels, and adipose cells with marked infiltration of inflammatory cells and bleeding. On immunohistochemical staining, the tumor was positive for human melanoma black-45. The tumor was diagnosed as inflammatory angiomyolipoma of the liver with intratumoral hemorrhage.
