Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Apr;11(4):452-7.
doi: 10.1007/s11605-006-0037-3.

Management of hepatic angiomyolipoma

Ching-Yao Yang  1 , Ming-Chih Ho, Yung-Ming Jeng, Rey-Heng Hu, Yao-Ming Wu, Po-Huang Lee
Affiliations

Management of hepatic angiomyolipoma

Ching-Yao Yang et al. J Gastrointest Surg. 2007 Apr.

Abstract

Preoperative diagnosis of hepatic angiomyolipoma is difficult, and the treatment for it remains controversial. The aim of this study is to review our experience in the treatment of hepatic angiomyolipoma and to propose a treatment strategy for this disease. We retrospectively collected the clinical, imaging, and pathological features of patients with hepatic angiomyolipoma. Immunohistochemical studies with antibodies for HMB-45, actin, S-100, cytokeratin, vimentin, and c-kit were performed. Treatment experience and long-term follow-up results are summarized. During a period of 9 years, 10 patients with hepatic angiomyolipoma were treated at our hospital. There was marked female predominance (nine patients). Nine patients received surgical resection without complications. One patient received nonoperative management with biopsy and follow-up. One patient died 11 months after surgery because of recurrent disease. We propose all symptomatic patients should receive surgical resection for hepatic angiomyolipoma. Conservative management with close follow-up is suggested in patients with asymptomatic tumors and meet the following criteria: (1) tumor size smaller than 5 cm, (2) angiomyolipoma proved through fine needle aspiration biopsy, (3) patients with good compliance, and (4) not a hepatitis virus carrier.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A 37-year-old woman (case 3) presented with fever and palpable abdominal mass. (a) The axial view of contrast-enhanced CT scans on portal venous phase shows a huge hepatic tumor at the left hepatic lobe with heterogeneous enhancement. Notice the engorged vessels within the tumor are vividly identified (arrow). (b) The MR coronal Tru FISP, fast imaging with steady-state precession. (TR/TE/FA = 4.3/2.1/72°) shows engorged vessels in the tumor. The right portal vein (arrow) is displaced by the tumor. (c) After 6 months of extended left lobectomy, the abdominal ultrasonography reveals a huge recurrent tumor (arrows) in the previous location of left hepatic lobe, and numerous smaller tumors in the right lobe. (d) Celiac angiography also demonstrates the recurrent huge tumor and other multiple smaller ones in the right lobe of liver. Note the early drainage vein (arrow).
Figure 2
Figure 2
Microscopic appearance of the hepatic angiomyolipoma in case 3. (a) The primary tumor is composed of polygonal to spindle cells arranged in solid sheets or trabecular pattern with endothelial lining. Some of the tumor cells have eosinophilic cytoplasm, and some have large fat vacuoles. Some of the nuclei are bizarre, and some have large eosinophilic nucleoli (H&E stain, original magnification ×100). (b) The tumor cells are strongly immunoreactive for HMB-45 (original magnification ×100). Recurrent tumor was noted 6 months later, and the patient received fine needle aspiration biopsy. (c) Microscopically, it shows tumor cells with clear to ample eosinophilic cytoplasm arranged in trabecular pattern (H&E stain, original magnification ×40). (d) Immunohistochemical staining shows the tumor cells are also positive for HMB-45 (original magnification ×200).
See this image and copyright information in PMC

References

    1. None
    2. Ishak KG. Mesenchymal tumors of the liver. In: Okuda K, Peters RL, eds. Hepatocellular carcinoma. New York: John Wiley and Sons:, 1976 247–307.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.jpedsurg.2004.08.036', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.jpedsurg.2004.08.036'}, {'type': 'PubMed', 'value': '15616929', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15616929/'}]}
    2. Kitano Y, Honna T, Nihei K, et al. Renal angiomyolipoma in Japanese tuberous sclerosis patients. J Pediatr Surg 2004;39:1784–6. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '11800647', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11800647/'}]}
    2. Makhlouf HR, Ishak KG, Shekar R, et al. Melanoma markers in angiomyolipoma of the liver and kidney: a comparative study. Arch Pathol Lab Med 2002;126:49–55. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '8147221', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/8147221/'}]}
    2. Ma TK, Tse MK, Tsui WM, et al. Fine needle aspiration diagnosis of angiomyolipoma of the liver using a cell block with immunohistochemical study. A case report. Acta Cytol 1994;38:257–60. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1002/(SICI)1097-0142(19990225)87:1<25::AID-CNCR5>3.0.CO;2-I', 'is_inner': False, 'url': 'https://doi.org/10.1002/(sici)1097-0142(19990225)87:1<25::aid-cncr5>3.0.co;2-i'}, {'type': 'PubMed', 'value': '10096356', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/10096356/'}]}
    2. Cha I, Cartwright D, Guis M, et al. Angiomyolipoma of the liver in fine-needle aspiration biopsies: its distinction from hepatocellular carcinoma. Cancer 1999;87:25–30. - PubMed