Background : Hepatic adenoma is a benign solid liver tumor. They are rare, tumors of epithelial origin and occur in less than 0.007-0.012% of the population. Hepatic adenomas are usually asymptomatic, about 25-50% may present with pain abdomen. Large adenomas have a tendency to rupture and bleed massively inside the abdomen. Whenever indicated surgical resection is a definitive treatment modality.

Methods : We present a unique case of a 65-year female who presented with progressive and deteriorating breathlessness for the last six months with hepatic adenoma compressing right lung , Inferior Vena Cava, and right ventricle for which emergency right hepatectomy was done with a right thoracoabdominal incision

Results : The patient was kept on mechanical ventilation postoperatively for 48hrs, and electively extubated on POD -3. In the postoperative period patient showed immediate improvement in symptoms and the patient was able to lie down in a supine position comfortably .and peripheral edema was reduced subsequently. The postoperative period was uneventful except for chylous ascitis, which was improved with conservative management and the patient was discharged in stable and satisfactory condition on Postoperative day 14.

Conclusions : Timely surgical intervention is needed to alleviate sypmtoms in such rare presentations of hepatic adenoma.