An intrahepatic adrenal adenoma mimicking hepatocellular carcinoma: A case report and literature review

Abstract Adrenal-hepatic fusion (AHF) with intrahepatic adrenocortical adenoma (IAA) is a rare condition that is often misdiagnosed as hepatocellular carcinoma (HCC) based on abdominal imaging. Herein, we report a case of IAA arising from AHF. A 78-year-old woman presented with dull epigastric pain for 6 months, and a tumor was identified in segment 7 of the liver. The lesion exhibited contrast enhancement during the arterial phase and hypodensity during the portal venous and delayed phases on computed tomography, raising suspicion for HCC. The patient subsequently underwent robotic wedge resection of the segment 7 liver tumor. Final pathological diagnosis confirmed the tumor as an IAA, which should be considered in the differential diagnosis of HCC when abdominal imaging reveals a lesion with an indistinct border adjacent to the right adrenal gland. Further improvement of nonsurgical diagnostic methods may improve preoperative differentiation.