Peliosis hepatis (PH) is a disease characterized by
multiple and small, blood-filled cysts within the
parenchymatous organs. PH is a very rare disease,
more common in adults, and when it affects the liver, it
comes to the surgeon’s attention only in an extremely
urgent situation after the lesion’s rupture with the
resulting hemoperitoneum. This report describes the
case of a 29-year-old woman affected by recurring
abdominal pain. CT scans showed a hepatic lesion
formed by multiple hypodense areas, which showed
an early acquisition of the contrast during the arterial
phase. Furthermore, it remained isodense with the
remaining parenchyma during the late venous phase.
We decided on performing a liver resection of segment
Ⅶ while avoiding a biopsy for safety reasons. The
histopathologic examination confirmed the diagnosis
of focal PH. PH should always be considered in the
differential diagnosis of hepatic lesions. Clinicians
should discuss the possible causes and issues related to
the differential diagnosis in addition to the appropriate
therapeutic approach. The fortuitous finding of a
lesion, potentially compatible with PH, requires elective
surgery with diagnostic and therapeutic intents. The
main aim is to prevent the risk of a sudden bleeding
that, in absence of properly equipped structures, may
have a fatal outcome