Spontaneous rupture of a hepatic angiomyolipoma: CT findings and literature review

Angiomyolipoma is an uncommon lipomatous neoplasm of the liver, usually asymptomatic and identified incidentally. We describe the CT findings of a surgically confirmed case of spontaneously ruptured angiomyolipoma with evidence of internal hemorrhage and hemoperitoneum. The CT features were that of an exophitic, oval, well-defined mass with inhomogeneous attenuation values due to the presence of fat- and soft-tissue densities. A review of the literature identified 49 cases of hepatic angiomyolipoma. Few of these occurred in symptomatic patients and showed intratumoral hemorrhagic foci, but none had a clear rupture with the external bleeding. To our knowledge, this is the first reported case with this complication.