A 30 year old woman presents with abdominal pain, your favorite chief complaint for that demographic. The pain is in the epigastric and RUQ areas. You note hepatomegaly with no Murphy's sign. Her urinary pregnancy test is negative; she protests, "I take my oral contraceptive religiously, like I have for the last fifteen years." You find that she's visited her primary care doctor multiple times with no diagnosis. Finally, you succumb to CT scan.
Whoa! You did not expect to see that. This CT shows a large complex enhancing mass of the left lobe of the liver with displaced vessels (small arrowheads). A smaller low attenuation mass is also noted in the right lobe of the liver.
While coming out of the CT scanner, she screams in pain and collapses. Her blood pressure is 60/palp. You start resuscitating her aggressively and the surgeons take her to the OR immediately. They find gross blood in the peritoneum.
Challenge: By textbook, this lesion is usually solitary in the right lobe of the liver, but this patient's history makes her prone to more complex lesions such as this one. What's the most likely diagnosis?
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