Exophytic hepatocellular carcinoma mimicking a large right adrenal incidentaloma complicated by intra-hepatic bile duct injury: a case report

Adrenal incidentaloma is defined as an adrenal mass measuring ≥1 cm that is incidentally detected on imaging studies performed for reasons unrelated to adrenal disease.Even in cases of non-functioning adrenal masses, surgical resection should be considered when the lesion measures >4 cm.However, when an adrenal mass is very large, particularly >10 cm, it may be difficult to determine whether the mass originates from the adrenal gland or the adjacent organs.In particular, a right-sided adrenal mass may rarely be misdiagnosed as exophytic hepatocellular carcinoma.Herein, we report a case of exophytic hepatocellular carcinoma in a 73-year-old male who was initially misdiagnosed as having a very large right adrenal incidentaloma measuring 12 cm, which led to adrenalectomy complicated by intra-hepatic bile duct injury.