BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack specificity.Thus,it is easy to misdiagnose HEA as other tumors of the liver,especially in the pre...BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack specificity.Thus,it is easy to misdiagnose HEA as other tumors of the liver,especially in the presence of liver diseases such as hepatitis cirrhosis.This article reviewed the diagnosis and treatment of a patient with HEA and alcoholic cirrhosis,and analyzed the literature,in order to improve the understanding of this disease.CASE SUMMARY A 67-year-old male patient with a history of alcoholic cirrhosis was admitted due to the discovery of a space-occupying lesion in the liver.Based on the patient’s history,laboratory examinations,and imaging examinations,a malignant liver tumor was considered and laparoscopic partial hepatectomy was performed.Postoperative pathology showed HEA.During outpatient follow-up,the patient showed no sign of recurrence.CONCLUSION HEA is difficult to make a definite diagnosis before surgery.HEA has the poten-tial for malignant degeneration.If conditions permit,surgical treatment is recom-mended.展开更多
BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and ima...BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques.Uncommon malignant tumors of the vascular endothelium include PHA.Another diagnosis that should not be overlooked when employing contrastenhanced MR and contrast-enhanced computed tomography(CT)imaging techniques is fat-poor AML,one of the uncommon vascular tumors of the liver.In both conditions,biopsy is the primary means of diagnosis.CASE SUMMARY In our article,besides the diagnosis of PHA,fat-poor AML,one of the other rare vascular tumors of the liver,is mentioned.In the case,a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain,weight loss,and nausea.Abdominal ultrasonography(US)revealed a hypoechoic heterogeneous lesion with occasional faint contours.In computed tomography,it was observed as a hyperdense nodular lesion in segment 4.Magnetic resonance imaging(MRI)revealed that the lesion did not contain fat.In connection with the known history of VHL Syndrome,we first evaluated the possibility of AML.Thereupon,a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5%fat content.CONCLUSION In conclusion,PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences.Important imaging techniques like contrast-enhanced US(CEUS),CECT,and CEMRI give us substantial advantages in both cases.However,a biopsy is used to provide the final diagnosis.展开更多
We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperat...We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma.展开更多
Angiomyolipoma （AML） is a benign mesenchymal tumor that has been frequently reported in the kidney but rarely in the liver. AML is composed of fat, vascular, and smooth muscle elements. Because the proportion of the...Angiomyolipoma （AML） is a benign mesenchymal tumor that has been frequently reported in the kidney but rarely in the liver. AML is composed of fat, vascular, and smooth muscle elements. Because the proportion of the constituents composed of AML are varied, hepatic AML may be clinically, radiologically and morphologically difficult to distinguish from hepatocellular carcinoma （HCC） or other hepatic lesions. Here we report a case with pathologically confirmed hepatic AML who was previously diagnosed as HCC based on imaging examinations.展开更多
基金Supported by Natural Science Foundation of Zhejiang Province,No.LY19H030004and The Lishui City Key Research and Ddevelopment Project,No.2022ZDYF08。
文摘BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack specificity.Thus,it is easy to misdiagnose HEA as other tumors of the liver,especially in the presence of liver diseases such as hepatitis cirrhosis.This article reviewed the diagnosis and treatment of a patient with HEA and alcoholic cirrhosis,and analyzed the literature,in order to improve the understanding of this disease.CASE SUMMARY A 67-year-old male patient with a history of alcoholic cirrhosis was admitted due to the discovery of a space-occupying lesion in the liver.Based on the patient’s history,laboratory examinations,and imaging examinations,a malignant liver tumor was considered and laparoscopic partial hepatectomy was performed.Postoperative pathology showed HEA.During outpatient follow-up,the patient showed no sign of recurrence.CONCLUSION HEA is difficult to make a definite diagnosis before surgery.HEA has the poten-tial for malignant degeneration.If conditions permit,surgical treatment is recom-mended.
文摘BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques.Uncommon malignant tumors of the vascular endothelium include PHA.Another diagnosis that should not be overlooked when employing contrastenhanced MR and contrast-enhanced computed tomography(CT)imaging techniques is fat-poor AML,one of the uncommon vascular tumors of the liver.In both conditions,biopsy is the primary means of diagnosis.CASE SUMMARY In our article,besides the diagnosis of PHA,fat-poor AML,one of the other rare vascular tumors of the liver,is mentioned.In the case,a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain,weight loss,and nausea.Abdominal ultrasonography(US)revealed a hypoechoic heterogeneous lesion with occasional faint contours.In computed tomography,it was observed as a hyperdense nodular lesion in segment 4.Magnetic resonance imaging(MRI)revealed that the lesion did not contain fat.In connection with the known history of VHL Syndrome,we first evaluated the possibility of AML.Thereupon,a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5%fat content.CONCLUSION In conclusion,PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences.Important imaging techniques like contrast-enhanced US(CEUS),CECT,and CEMRI give us substantial advantages in both cases.However,a biopsy is used to provide the final diagnosis.
文摘We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma.
文摘Angiomyolipoma （AML） is a benign mesenchymal tumor that has been frequently reported in the kidney but rarely in the liver. AML is composed of fat, vascular, and smooth muscle elements. Because the proportion of the constituents composed of AML are varied, hepatic AML may be clinically, radiologically and morphologically difficult to distinguish from hepatocellular carcinoma （HCC） or other hepatic lesions. Here we report a case with pathologically confirmed hepatic AML who was previously diagnosed as HCC based on imaging examinations.
