Adult Solid Hepatic Mesenchymal Hamartoma Masquerading as Malignancy

Solid Hepatic Mesenchymal Hamartoma (HMH) rarely occurs in adults. We report two cases of solid adult HMH. A 62-year-old female with right upper abdominal pain on Computed Tomography (CT) scan revealed a well defined heterogeneously enhancing solid mass lesion in segment VII of liver along with non-enhancing central necrotic areas. Percutaneous biopsy and intraoperative frozen section were inconclusive and conventional right hepatectomy was done. Final histopathology was solid HMH. Another 63-year-old female with right upper abdominal pain had cirrhotic liver, choledocholithiases, cholelithiases, mild ascites and a right lobe lesion with calcifications on CT scan. Ultrasound guided biopsy showed fibrocollagenous tissue. She was operated for a right hepatectomy and choledochoduodenostomy. Final histopathology revealed solid HMH. Though solid adult HMH is rare, it should be considered in differential diagnosis of solid/cystic/focal or multifocal liver lesions and surgical resection to negative margins is the treatment of choice