title: Hepatic angiomyolipoma mimicking hepatocellular carcinoma: magnetic resonance imaging and clinical pathological characteristics in 9 cases.
abstract: Hepatic angiomyolipoma (HAML) is a rare mesenchymal tumor of the liver with marked histological diversity. The present study was to review the magnetic resonance imaging (MRI) and clinical pathological features of HAML resembling hepatocellular carcinoma (HCC). Nine patients who underwent surgical resection and had pathological diagnosis of HAML were retrospectively analyzed. All of 9 patients (5 males and 4 females) had a solitary hepatic mass with a median size of 4 cm (from 1.4 cm to 15.3 cm). Seven cases were identified as incidental liver tumors during health screening and 2 patients were diagnosed for hepatic mass when visited hospitals with unspecific abdominal discomfort. Before resection, 6 cases were diagnosed as HCC on MRI. MRI on chemical shift imagings showed a large amount of lipids in 5 cases. The enhancement pattern of MRI was classified into 2 types: in 2 cases, lesions with small or no vessels that demonstrated prolonged enhancement (1 mixed subtype and 1 myomatous subtype) and in 7 cases, lesions with abundant central vessels that show rapid washout (3 mixed subtypes and 4 myomatous subtypes) in the portal venous/delayed phase. All patients underwent resection of hepatic tumor and no recurrence was observed during follow-up (range: 2-24 months) of median 10 months. By immunohistochemistry, the tumor cells demonstrated positive immunostaining for human melanoma black-45, smooth muscle actin, and CD34. In conclusion, all of 9 patients with HAML presented with none or nonspecific clinical manifestations. The diagnosis of HAML relies on disease and immunohistochemistry, but not MRI due to its resemblance to HCC.
authors.affiliation: From the Center of Therapeutic Research for Liver Cancer (C-PW, H-YL, HW, X-DG, J-HQ, ZL, X-JC, Y-YL, ZZ, ML, Y-PY); Center of Pathology (X-DG, S-HL); and Center of Radiology (C-CL), 302 Military Hospital, Beijing, China.
authors.forename: Chun-Ping
authors.initials: CP
authors.lastname: Wang
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Guo
authors.forename: Chang-Chun
authors.initials: CC
authors.lastname: Liu
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Liu
authors.forename: Xu-Dong
authors.initials: XD
authors.lastname: Gao
authors.forename: Jian-Hui
authors.initials: JH
authors.lastname: Qu
authors.forename: Ze
authors.initials: Z
authors.lastname: Liu
authors.forename: Xiu-Juan
authors.initials: XJ
authors.lastname: Chang
authors.forename: Yin-Ying
authors.initials: YY
authors.lastname: Lu
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zeng
authors.forename: Min
authors.initials: M
authors.lastname: Lou
authors.forename: Yong-Ping
authors.initials: YP
authors.lastname: Yang
mesh_terms: D000328:Adult; D018207:Angiomyolipoma / Q000175:diagnosis* / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors