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Focal nodular hyperplasia and hepatocellular adenoma are benign hepatic tumors anddifferential diagnosis is important as hepatic adenomas may complicate with hemorrhage and malignanttransformation. Magnetic resonance imaging with gadolinium-enhanced contrast agents is the best noninvasive diagnostic tool for benign hepatic tumors. Nevertheless, atypical radiological findings can makedifferential diagnosis a challenge.Presentation of case: We report a young female patient with large hepatic benign tumor with intralesionalhemorrhage that disclosed hyper-intensity on hepatobiliary phase on a gadolinium-enhanced magneticresonance imaging study, suggestive of focal nodular hyperplasia. As this type of tumor usually do notcomplicate with bleeding, surgical resection was proposed and a laparoscopic right posterior hepaticsectionectomy with selective hepatic artery clamping was performed. Pathology disclosed an inflammatoryhepatic adenoma.Discussion: Hepatic adenomas may present as hyper-intense tumors on hepatobiliary phase of gadoliniumenhanced magnetic resonance imaging. Surgical resection still has a role on the treatment of benign hepatictumors. Laparoscopic liver resections must be considered, even when a major hepatectomy is planned, asthis approach has proved safe and effective. Selective hepatic artery clamping during minimally invasiveliver surgery may be an option to reduce intraoperative bleeding, remnant liver ischemia and postoperativehepatic failure.Conclusion: We reported a young female patient with a benign hepatic tumor complicated with hemorrhagesuggestive of a focal nodular hyperplasia on gadolinium-enhanced magnetic resonance imaging study. Alaparoscopic hepatectomy was performed and final pathology disclosed an inflammatory hepatocellularadenoma.

international journal of surgical case reports.

Laparoscopic Hepatectomy with Selective Hepatic Artery Clamping for A Hyperintense Hepatic Adenoma on Hepatospecific Gadolinium-Enhanced Magnetic Resonance Imaging: The Great Pretender