Exophytic Hepatic Hemangioma Mimicking a Right Adrenal Gland Mass: A Diagnostic Challenge

Hepatic hemangiomas are highly common benign tumors of the liver that are typically composed of vascular channels and are often discovered incidentally due to their asymptomatic nature. While the majority are intraparenchymal, exophytic hepatic hemangiomas are a rare occurrence that may mimic lesions from an adjacent organ. This case presents an unusual occurrence of an exophytic hepatic hemangioma in a 66-year-old male that closely mimicked a right adrenal gland mass on an incidental fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography or ¹⁸F-FDG PET/CT taken for the diagnosis of multiple myeloma. The atypical location and radiologic appearance complicated the initial diagnostic impression, highlighting the importance of considering exophytic hepatic hemangiomas in the differential diagnosis of adrenal and retroperitoneal masses. Recognition of this occurrence is critical to avoid unnecessary interventions and ensure appropriate patient management.