title: Hepatic angiomyolipoma: a clinical experience in diagnosis and treatment.
abstract: BACKGROUND
  Hepatic angiomyolipoma is a rare mesenchyme-derived neoplasm often misdiagnosed as hepatocellular carcinoma, and the treatment for it remains controversial.
  
  
  OBJECTIVE
  To develop the optimal preoperative diagnoses means and treatment modalities of hepatic angiomyolipoma.
  
  
  METHODS
  Retrospective analysis of the clinical features, treatment, and prognostic data of 17 hepatic AML patients admitted to Chinese People's Liberation Army Generation Hospital between 1996 and 2006.
  
  
  RESULTS
  Most hepatic angiomyolipoma were solitary. The overall preoperative diagnostic rate was 18% and the most common misdiagnosis was hepatocellular carcinoma (10/17, 59%). In three patients, observation was performed for 2-3 years before being admitted. The tumors increased 1-9 cm in size in all patients. All of the 17 patients finally received various liver resection procedures, and postoperative mortality and morbidity was 0 and 12% (2/17). After a median follow-up period of 73 months, the tumor recurred only in one patient 9 years post-operatively.
  
  
  CONCLUSIONS
  Hepatic angiomyolipoma should be suspected in liver tumor patients with normal α-fetoprotein levels and no concomitant hepatitis. Preoperative MRI combined with percutaneous fine-needle biopsy should be the diagnostic methods of choice. Small hepatic AML proved through pathologic examination (<5 cm) may be managed by observation with close follow-up, but surgery is indicated in patients suffering from large tumors or significantly larger tumors during follow-up.
authors.affiliation: Hospital & Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, 28 Fu-Xing Road, Haidian District, Beijing, China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Zeng
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Dong
authors.forename: Wen-Zhi
authors.initials: WZ
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Pang
mesh_terms: D000328:Adult; D018207:Angiomyolipoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D044963:Biopsy, Fine-Needle; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins