We present a case of giant hepatic angiomyolipoma (HAML) in a 54-year-old female. Clinical manifestation of this entity is vague and imaging plays a major role in diagnosis. The presence of fat and efferent draining hepatic vein with early arterial enhancement persisting into the portal venous phase favors diagnosis of HAML. However, radiological findings can be confusing as in this case, and final diagnosis is made by histopathology and immunohistochemistry with positivity for human melanoma black-45.
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