Hepatic adenoma: an observation from asymptomatic stage to rupture

A 39 year old female, who took oral contraceptives for about ten years, was found to have an asymptomatic hepatic adenoma during an episode of acute hyperlipidemic pancreatitis. The diagnosis was confirmed by sonography, CT scan, angiography, and liver biopsy. She refused operation and was followed at the outpatient clinic. Initially, the tumor decreased its size after withdrawal of oral contraceptives, but enlarged again on subsequent examinations. She came back to emergency room with hemoperitoneum and intratumoral hemorrhage eighteen months after the initial diagnosis. Her hepatic adenoma was removed surgically and was found to be ruptured. She has been well for two years.