Diagnosis and treatment of hepatic angiomyolipoma

J Surg Oncol. 2011 Jun;103(8):807-12. doi: 10.1002/jso.21814. Epub 2011 Jan 31.

Abstract

Background and objective: Hepatic angiomyolipoma is more frequently encountered in clinical practice, its diagnosis is difficult, its treatment remains controversial. We review a single-center experience in the treatment of hepatic angiomyolipoma.

Method: The clinical data of 79 patients with hepatic angiomyolipoma treated at the authors' institute between January 1992 and December 2006 were retrospectively reviewed.

Results: During a period of 15 years, a total of 79 patients with hepatic angiomyolipoma underwent liver resection at our hospital. There are 58 women and 21 men. The tumor size varied from 1 to 25 cm in diameter (6.1 ± 4.08). Fifty-four patients (68%) were asymptomatic. Accurate preoperative diagnosis was made in 41 patients (52%). Tumors less than 6 cm in size were more frequently misdiagnosed. Spontaneous rupture occurred in one patient. One patient had tumor recurrence 6 years after the surgery, and died of the disease 1 year later. Symptom relief was achieved in 92% of the symptomatic patients. Median survival was 90 months (90.12 ± 30.84).

Conclusions: Hepatic angiomyolipoma poses a diagnostic challenge clinically and radiologically. Surgical resection is a safe and effective treatment option. It is important to realize the potential of malignant transformation and risk of rupture as life-threatening complications.

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Adult
  • Aged
  • Angiomyolipoma / diagnosis*
  • Angiomyolipoma / mortality
  • Angiomyolipoma / surgery*
  • Diagnostic Imaging
  • Female
  • Hepatitis B Surface Antigens / blood
  • Hepatitis C Antibodies / blood
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Rupture, Spontaneous
  • Sex Distribution

Substances

  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies