title: Malignant hepatic epithelioid angiomyolipoma with recurrence in the lung 7 years after hepatectomy: a case report and literature review.
abstract: Angiomyolipoma (AML) arising in the liver is rare and usually benign, but it occasionally has malignant potential. A 58-year-old man with a liver tumor identified by a previous doctor with features suggestive of hepatocellular carcinoma on computed tomography (CT) underwent anterior segmentectomy of the liver in 2006. Microscopically, the tumor was composed of exclusively epithelioid cells that were scatteredly positive for human melanoma black 45 on immunohistochemistry. Accordingly, primary hepatic epithelioid AML (eAML) was diagnosed. The patient was subsequently referred to our hospital for follow-up after hepatectomy. He had event-free survival for nearly 7 years. In 2013, two well-defined round nodules were detected in the right lung field by chest CT, and partial pneumonectomy was performed for diagnosis and treatment. Histological examination of the resected lung tissue showed that it was morphologically and immunohistochemically identical to his primary hepatic eAML, leading to the diagnosis of pulmonary metastasis. This paper demonstrates a rare case of malignant hepatic eAML with late recurrence in the lung after hepatectomy.
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan. yfukuda@gesurg.med.osaka-u.ac.jp.|Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-5111, Osaka, Japan. yfukuda@gesurg.med.osaka-u.ac.jp.
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Fukuda
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Omiya
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Takami
authors.affiliation: Department of Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mano
authors.affiliation: Department of Gastroenterological Surgery, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Nomura
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Akiba
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yano
authors.affiliation: Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Ogawara
authors.affiliation: Department of Gastroenterology and Hepatology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
keywords: Hepatic angiomyolipoma; Malignant potential; Perivascular epithelioid cell