Spontaneous intrahepatic hematoma caused by hepatocellular carcinoma is a rare condition since usually the circumference shows liver cirrhosis. We report a case of hepatocellular carcinoma with an intrahepatic hematoma. A 79-year-old man was admitted to our hospital with sudden onset upper abdominal pain and high fever. Laboratory data showed that the patient had liver dysfunction but was not anemic. Abdominal computed tomography( CT) revealed an intrahepatic tumor with a hematoma measuring 8.5 cm in diameter in the right lobe of the liver. An enhancing lesion and pooling of contrast media inside the tumor was observed. Angiography also revealed a microaneurysm in the tumor. The patient underwent right hepatic lobectomy, and histopathological examination showed hepatocellular carcinoma.

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