Ann Hepatobiliary Pancreat Surg.  2021 May;25(2):215-220. 10.14701/ahbps.2021.25.2.215.

Clinicopathological correlation and post-resection outcomes of hepatic angiomyolipoma

• Yang G
• Hwang S
• Ahn CS
• Kim KH
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Hong SM

• KMID: 2516242
• DOI: http://doi.org/10.14701/ahbps.2021.25.2.215

Abstract

Backgrounds/Aims
Angiomyolipoma is a rare neoplasm of mesenchymal origin derived from perivascular epithelioid cells. Due to rarity, hepatic angiomyolipoma (HAML) has been often misdiagnosed as hepatocellular carcinoma (HCC) or other hypervascular liver tumors based on imaging studies. This study investigated the clinicopathological correlation and post-resection outcomes of HAML.
Methods
This retrospective observational study included 40 patients who underwent hepatic resection (HR) for HAML between 2008 and 2018.
Results
Mean age of the patients was 42.6±11.4 years and there were 30 (75.0%) females. Hepatitis B and C virus infection was present in 8 patients (20.0%) and 1 patient (2.5%), respectively. Preoperative diagnoses on imaging studies were HCC in 23 (57.5%) patients, HAML in 14 (35.0%) patients, focal nodular hyperplasia in 2 (5.0%) patients, and hepatic adenoma in 1 (2.5%) patient. Percutaneous liver biopsy was performed in 10 (25.0%) patients and HAML was diagnosed in all patients. Only 3 patients (7.5%) showed a slight elevation in the level of liver tumor markers. Major HR was performed in 10 (25.0%). Laparoscopic HR was performed in 9 (22.5%). The mean tumor size was 4.8±3.9 cm and single tumor was present in 38 (95.0%) patients. Currently, all the patients are alive without tumor recurrence during the follow-up observation period of 75.7±37.3 months.
Conclusions
HAML is a rare form of primary liver tumor and is often misdiagnosed as HCC or other hypervascular tumors. Although HAML is benign in nature, it has malignant potential, thus resection is indicated if the tumor grows or malignancy cannot be excluded.

Keyword

Immunohistochemical stain; Perivascular epithelioid cell tumor; Mesenchymal origin; Malignant potential; Hepatocellular carcinoma

Figure

• 

  Fig. 1 Preoperative computed tomography findings and gross photographs of the surgical spe-cimens of patients with a clini-cal diagnosis of hepatic angio-myolipoma. (A) A 17 cm-sized large mass was presented with abdominal discomfort as a result of compression symptoms. (B) A 8.4 cm-sized mass was detect-ed at routine follow-up imaging studies following kidney trans-plantation. (C) A 2.7 cm-sized mass was detected at the rou-tine health screening.

• 

  Fig. 2 Preoperative computed tomography findings and gross photographs of the surgical spe-cimens of patients with a clini-cal diagnosis of hepatocellular carcinoma. (A) A 8 cm-sized mass was detected at the rou-tine health screening. (B) A 8 cm-sized mass was presented with abdominal discomfort. (C) A 4 cm-sized mass was detect-ed at the routine health screening.

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