Juxta-caval hepatic angiomyolipoma masquerading as hepatocellular carcinoma.
Hepatic angiomyolipoma is an uncommon primary benign epithelial liver neoplasm. Most patients with angiomyolipomas are middle-aged women who commonly present with epigastric fullness or pain. Angiomyolipomas are tumors consisting of three tissue types: blood vessels, smooth muscle, and fat. Hepatic angiomyolipomas may be difficult to differentiate from other liver neoplasms by noninvasive imaging. We report a 58-year-old asymptomatic woman with a mass in the right lobe of the liver, found incidentally on routine abdominal sonography. Preoperative radiographic evaluation revealed a 6.5-cm hypervascular lesion abutting the inferior vena cava. Preoperative histologic study demonstrated an epithelial neoplasm suspicious for hepatocellular carcinoma. Metastatic workup was negative. At resection, the tumor was found to be an angiomyolipoma composed of lipoid, vascular and smooth muscle cells. Further staining was positive for HMB-45. Resection margins were negative. The woman had an uneventful recovery and was discharged on postoperative day seven. She currently remains well several months after her right hepatectomy.
Hawxby
Alan M
AM
Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD 21287, USA. ahawxby1@jhmi.edu
Torbenson
Michael
M
Fishman
Elliot
E
Lawler
Leo
L
Arrazola
Luis M
LM
Klein
Andrew S
AS
D018207:Angiomyolipoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D003287:Contrast Media