A 62-year-old woman consulted for pain in the right hypochondrium without any other symptoms or history of interest.
Physical examination: a large mass in the left hemiliver.
Abdominal CT and hepatic MRI: well-defined tumor in segments II and III of the liver, apparently encapsulated, with areas of bleeding and necrosis of nonspecific characteristics; it is suggested the diagnosis of hepatic adenoma without ruling out other tumors.
Operation: enucleation of a single round, soft hepatic tumor with a vascular component on a surface that macroscopically seems compatible with hemangioma.
Pathological anatomy: mixed hepatic angiomyolipoma (smooth muscle tissue, adipose tissue and tortuous vessels).
Immunohistochemistry: HMB-45+ in muscle tumor cells; vimentin +, S100+ and actin +; CD10, desmin, c-kit, EMA1/AE 5.2, CD34 AE.
Results: the patient was discharged on the 7th postoperative day with pain relief.
