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A 68-year-old man was admitted with a palpable liver and a defect in scintigram. Selective celiac arteriography showed a rounded hypervascular tumor with the diameter of 13.5 cm situated in the bifurcation of the hepatic artery. Laparotomy revealed that the liver was normal in appearance and tumor was not palpable. However, needle and wedge biopsy examination dis-closed hepatoma deep in the liver with hepatic fibrosis.Inspection and palpation at operation are not always reliable guidelines and open biopsy should be utilized for the identification of liver cancer and concomitant diseases and to determine the resectional line at the time of hepatectomy.

A LARGE HEPATOMA WITHOUT APPARENT ABNORMALITY ON LAPAROTOMY