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Hepatic angiomyolipoma with concomitant hepatocellular carcinomas
Y C Chang1, H M Tsai, N H Chow
1Department of Surgery, National Cheng Kung University Medical Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, Tainan 70428, Taiwan. changyc@mail.ncku.edu.tw
Hepato-Gastroenterology
|March 28, 2001
Summary
Hepatic angiomyolipoma, a rare liver tumor, can coexist with hepatocellular carcinoma, especially in hepatitis B carriers. This case highlights the need for caution with non-surgical treatment due to diagnostic challenges.
Area of Science:
- Hepatology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Angiomyolipoma is a rare, benign lipomatous liver tumor.
- Non-surgical management is typically recommended due to its benign nature.
- Hepatocellular carcinoma (HCC) is a significant concern in hepatitis B carriers.
Observation:
- A case of hepatic angiomyolipoma co-occurring with two hepatocellular carcinomas in a hepatitis B carrier was identified.
- Despite normal alpha-fetoprotein levels, lesions were resected based on clinical suspicion.
- Pathological examination confirmed a typical angiomyolipoma and two well-differentiated HCCs with fatty metamorphosis.
Findings:
- This is the first reported instance of hepatic angiomyolipoma coexisting with hepatocellular carcinoma.
- The presence of fat-rich HCCs complicates preoperative diagnosis, even with advanced imaging.
- Serum alpha-fetoprotein levels may not be elevated in all HCC cases.
Implications:
- Non-surgical treatment of hepatic angiomyolipoma requires careful consideration in HCC-endemic regions.
- Diagnostic challenges posed by co-existing fatty HCC necessitate heightened clinical vigilance.
- Further research is needed to refine diagnostic and management strategies for these rare co-occurrences.