Hepatic angiomyolipoma: an international multicenter analysis on diagnosis, management and outcome
| Autor: | Johann Pratschke, Robert A. de Man, Wenzel Schöning, Joal D. Beane, Silvia Pellegrino, Valérie Paradis, Michael A. Nalesnik, Steven Sun, Verena Tripke, Moritz Schmelzle, Olivier Soubrane, Jan N. M. IJzermans, Hauke Lang, Anne J. Klompenhouwer, Roy S. Dwarkasing, Valérie Vilgrain, Eliza W. Beal, Michael Doukas, David A. Geller, Timothy M. Pawlik |
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| Přispěvatelé: | Surgery, Radiology & Nuclear Medicine, Pathology, Gastroenterology & Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Databases Factual Hepatic Angiomyolipoma medicine.medical_treatment Angiomyolipoma Patient characteristics Liver transplantation Malignancy Resection 03 medical and health sciences 0302 clinical medicine Biopsy medicine Hepatectomy Humans Retrospective Studies Hepatology medicine.diagnostic_test business.industry Liver Neoplasms Gastroenterology Middle Aged medicine.disease Magnetic Resonance Imaging Treatment Outcome Multicenter study 030220 oncology & carcinogenesis Diagnosis management Female 030211 gastroenterology & hepatology Radiology Tomography X-Ray Computed business |
| Zdroj: | HPB, 22(4), 622-629. John Wiley & Sons Inc. |
| ISSN: | 1477-2574 1365-182X |
| Popis: | Background Hepatic angiomyolipoma (HAML) may easily be misdiagnosed as a malignancy. The study aim was to assess diagnostic dilemmas, clinical management and outcome of this rare tumor. Methods This retrospective international multicenter study included all patients with pathologically proven HAML diagnosed between 1997 and 2017. Data on patient characteristics, diagnostic work-up, management and follow-up were analyzed. Results Thirty-eight patients were included, 32 female. Median age was 56yrs (i.q.r. 43–64) and median HAML-diameter was 57.5 mm (i.q.r. 38.5–95.3). Thirty patients had undergone CT and 27/38 MRI of the liver, diagnostic biopsy was performed in 19/38. Initial diagnosis was incorrect in 15/38 patients, of which 13 were thought to have malignancy. In 84% biopsy resulted in a correct preoperative diagnosis. Twenty-nine patients were managed with surgical resection, 4/38 with surveillance and 3/38 with liver transplantation. Recurrence after resection occurred in two cases. No HAML related deaths or progression to malignancy were documented. Conclusion HAML diagnosis proved problematic even in hepatobiliary expertise centers. Biopsy is indicated and may provide valuable additional information when HAML diagnosis is considered on cross-sectional imaging, especially when surgical resection imposes a risk of complications. Conservative management with regular imaging follow-up might be justified when biopsy confirms (classic type) HAML. |
| Databáze: | OpenAIRE |
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