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Sporadic exophytic hepatic angiomyolipoma
Sílvia Costa1, David Tente, Alexandre Costa
1Department of Surgery, Centro Hospitalar Gaia/Espinho, EPE, Gaia, Portugal. sisse.costa@gmail.com
BMJ Case Reports
|October 13, 2012
Summary
Hepatic angiomyolipomas, rare tumors of the liver, require surgical excision due to potential malignant behavior. This case highlights surgical management for a large liver angiomyolipoma.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Angiomyolipomas are rare mesenchymal tumors composed of smooth muscle, blood vessels, and adipocytes.
- Hepatic angiomyolipomas are exceptionally rare, with fewer than 200 reported cases since 1976.
- These tumors are typically found in the kidneys, with extrarenal locations being uncommon.
Observation:
- A 59-year-old woman presented with a 6 cm hepatic angiomyolipoma in segments II and III.
- The patient also had gallbladder issues, including parietal calcification and lithiasis.
- The tumor was surgically removed via bisegmentectomy (segments II and III) along with cholecystectomy.
Findings:
- Pathological examination confirmed hepatic angiomyolipoma, with positive HMB45 and focal HHF35 staining.
- The gallbladder exhibited chronic cholecystitis.
- The surgical procedure was performed without complications.
Implications:
- While typically benign, hepatic angiomyolipomas can exhibit malignant behavior, including recurrence and metastasis.
- The potential for malignancy has shifted the management approach from surveillance to surgical excision.
- This case underscores the importance of surgical intervention for large or symptomatic hepatic angiomyolipomas.
