A case of huge hepatocellular adenoma (HCA), which was very difficult to differentiate from well-differentiated hepatocellular carcinoma (HCC), is reported. Also, the angiographic characteristics of both HCC and HCA, 12 cases of mononodal type HCC (capsulated type: 2 cases, uncapsulated type: 10 cases) and 3 cases of HCA including the reported case which sized over 8 cm in diameter, were compared. Like HCC, HCA appears as rounded relatively homogeneous hypervascular mass that stretch markedly the dilated hepatic artery branches. In HCA, numerous small vascular branches, which perforate toward the center of the tumor from the displaced branches, shows regular vascular running and even vascular caliber as if brushed over, compared with irregular vascular running and uneven vascular caliber with abrupt interruption for HCC. Angiographic characteristics of the tumor such as tumor staining, its boundary, vascular running and vascular caliber, play an important role to differentiate HCA from HCC.
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