Hepatic Angiomyolipoma: a Retrospective Study of 25 Cases

Overview

Journal Surg Today

Specialty General Surgery

Date 2008 Jun 3

PMID 18516533

Citations 13

Authors

Tao Li

Lu Wang

Hai-Hua Yu

Hui-Chuan Sun

Lun-Xiu Qin

Qing-Hai Ye

Jia Fan

Zhao-You Tang

Affiliations

Soon will be listed here.

Abstract

Purpose: We report our experience of diagnosing and treating hepatic angiomyolipoma (HAML), a rare benign mesenchymal tumor.

Methods: We analyzed retrospectively the clinicopathologic, radiological, and operative data of 25 patients who underwent surgery for HAML at our institute between November 2001 and May 2006.

Results: Most patients (20/25) were asymptomatic and had normal liver function. Ultrasonography (US) showed a heterogeneous hyperechoic mass in 13 of 23 patients, precontrast computed tomography (CT) showed that all of 12 lesions scanned were hypodense, and magnetic resonance imaging (MRI) showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in most (5/6) lesions. Marked enhancement in the arterial phase was seen in 10 of 12 lesions on CT scans and in 6 of 6 lesions on MRI scans. All tumors were composed of varying proportions of smooth muscle, adipose tissue, and blood vessels, and showed positive immunohistochemical staining for HMB-45. All patients underwent partial hepatectomy and there was no evidence of recurrence after a median follow-up of 43 months.

Conclusion: The radiological features of HAML vary according to its histological components. The definitive diagnosis of HAML is challenging and depends on the presence of HMB-45-positive myoid cells. Hepatic angiomyolipoma is treated effectively with surgery and the prognosis is good.

Citing Articles

Hepatic Perivascular Epithelioid Cell Tumor Mimicking Hepatocellular Carcinoma.

Harwal R, Joseph Rosemary L, Raju P, Chidambaranathan S, Bharathi Vidya Jayanthi J, Obla Lakshmanamoorthy N ACG Case Rep J. 2023; 10(1):e00962.

PMID: 36699186 PMC: 9857397. DOI: 10.14309/crj.0000000000000962.

Anastomosing haemangioma of liver: A case report.

Peng X, Li J, Liang Z Mol Clin Oncol. 2017; 7(3):507-509.

PMID: 28808574 PMC: 5543263. DOI: 10.3892/mco.2017.1341.

Tuberous sclerosis associated with multiple hepatic lipomatous tumours.

Calleja-Stafrace D, Vella C Images Paediatr Cardiol. 2017; 18(4):1-4.

PMID: 28405209 PMC: 5270032.

Hepatic falciform ligament clear cell myomelanocytic tumor: A case report and a comprehensive review of the literature on perivascular epithelioid cell tumors.

Wang Z, Xu L, Ma L, Song M, Wu L, Zhou X BMC Cancer. 2015; 15:1004.

PMID: 26698563 PMC: 4690247. DOI: 10.1186/s12885-015-1992-4.

Ruptured hepatic epithelioid angiomyolipoma: a case report and literature review.

Tajima S, Suzuki A, Suzumura K Case Rep Oncol. 2014; 7(2):369-75.

PMID: 24987358 PMC: 4067709. DOI: 10.1159/000363690.

References

Dalle I, Sciot R, De Vos R, Aerts R, Van Damme B, Desmet V . Malignant angiomyolipoma of the liver: a hitherto unreported variant. Histopathology. 2000; 36(5):443-50. DOI: 10.1046/j.1365-2559.2000.00891.x. View

Terris B, Flejou J, Picot R, Belghiti J, Henin D . Hepatic angiomyolipoma. A report of four cases with immunohistochemical and DNA-flow cytometric studies. Arch Pathol Lab Med. 1996; 120(1):68-72. View

Tsui W, Colombari R, Portmann B, Bonetti F, Thung S, Ferrell L . Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol. 1999; 23(1):34-48. DOI: 10.1097/00000478-199901000-00004. View

Marcheix B, Brouchet L, Lamarche Y, Renaud C, Gomez-Brouchet A, Hollington L . Pulmonary angiomyolipoma. Ann Thorac Surg. 2006; 82(4):1504-6. DOI: 10.1016/j.athoracsur.2006.02.053. View

Yeh C, Lee K, Chen M . Immunohistochemical study of hepatic angiomyolipoma. Hepatogastroenterology. 2005; 52(64):1151-3. View

Rouquie D, Eggenspieler P, Algayres J, Bechade D, Camparo P, Baranger B . [Malignant-like angiomyolipoma of the liver: report of one case and review of the literature]. Ann Chir. 2006; 131(5):338-41. DOI: 10.1016/j.anchir.2005.11.014. View

Makhlouf H, Remotti H, Ishak K . Expression of KIT (CD117) in angiomyolipoma. Am J Surg Pathol. 2002; 26(4):493-7. DOI: 10.1097/00000478-200204000-00012. View

Tryggvason G, Blondal S, Goldin R, Albrechtsen J, Bjornsson J, Jonasson J . Epithelioid angiomyolipoma of the liver: case report and review of the literature. APMIS. 2004; 112(9):612-6. DOI: 10.1111/j.1600-0463.2004.apm1120909.x. View

Hiromura T, Nishioka T, Tomita K . Spontaneous rupture of renal angiomyolipoma: value of multidetector CT angiography for interventional therapy. Emerg Radiol. 2005; 12(1-2):53-4. DOI: 10.1007/s10140-005-0445-9. View

10.

Ren N, Qin L, Tang Z, Wu Z, Fan J . Diagnosis and treatment of hepatic angiomyolipoma in 26 cases. World J Gastroenterol. 2003; 9(8):1856-8. PMC: 4611561. DOI: 10.3748/wjg.v9.i8.1856. View

11.

Hogemann D, Flemming P, Kreipe H, Galanski M . Correlation of MRI and CT findings with histopathology in hepatic angiomyolipoma. Eur Radiol. 2001; 11(8):1389-95. DOI: 10.1007/s003300000750. View

12.

McKinney C, Geiger J, Castle V, Ruiz R, Strouse P . Aggressive hepatic angiomyolipoma in a child. Pediatr Hematol Oncol. 2005; 22(1):17-24. DOI: 10.1080/08880010590896206. View

13.

Hsu Y, Chen R, Fang J, Lin B . Traumatic rupture of renal angiomyolipoma managed with angioembolization followed by elective surgery: a report of two cases. J Trauma. 2005; 59(3):737-41. View

14.

Pancholi V, Munjal K, Jain M, Munjal S, Agrawal R, Nandedkar S . Preoperative diagnosis of renal angiomyolipoma with fine needle aspiration cytology: a report of 3 cases. Acta Cytol. 2006; 50(4):466-8. DOI: 10.1159/000325994. View

15.

Wang S, Tsai K, Lee K . Hepatic angiomyolipoma with trace amounts of fat: a case report and literature review. J Clin Pathol. 2006; 59(11):1196-9. PMC: 1860516. DOI: 10.1136/jcp.2005.027227. View

16.

Kannangai R, Diehl A, Sicklick J, Rojkind M, Thomas D, Torbenson M . Hepatic angiomyolipoma and hepatic stellate cells share a similar gene expression profile. Hum Pathol. 2005; 36(4):341-7. DOI: 10.1016/j.humpath.2005.01.002. View

17.

Guidi G, Catalano O, Rotondo A . Spontaneous rupture of a hepatic angiomyolipoma: CT findings and literature review. Eur Radiol. 1997; 7(3):335-7. DOI: 10.1007/s003300050162. View

18.

Nonomura A, Enomoto Y, Takeda M, Tamura T, Kasai T, Yosikawa T . Invasive growth of hepatic angiomyolipoma; a hitherto unreported ominous histological feature. Histopathology. 2006; 48(7):831-5. DOI: 10.1111/j.1365-2559.2006.02427.x. View

19.

Saito M, Tsukamoto T, Takahashi T, Sai K, Fujii H, Nagashima K . Multifocal angiomyolipoma affecting the liver and lung without tuberous sclerosis. J Clin Pathol. 2004; 57(2):221-4. PMC: 1770191. DOI: 10.1136/jcp.2003.10330. View

20.

Soyer P, Bluemke D, Hruban R, Fishman E . [Hepatic angiomyolipoma. Magnetic resonance imaging and imaging by CT-xray]. J Radiol. 1995; 76(1):45-50. View