Clinical characteristics and outcomes of patients with hepatic angiomyolipoma: A literature review
| Autor: | Eric Delabrousse, Anne Julia Klompenhouwer, Paul Calame, Gaëlle Tyrode, Thierry Thevenot, Delphine Weil Verhoeven, Vincent Di Martino, Sophie Félix |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty Liver tumor Angiomyolipoma Carcinoma Hepatocellular Imaging 03 medical and health sciences Tuberous sclerosis Potentially malignant 0302 clinical medicine medicine Humans Pathological medicine.diagnostic_test business.industry Liver Neoplasms Gastroenterology Histology Magnetic resonance imaging Minireviews General Medicine Middle Aged medicine.disease Liver Tuberous sclerosis complex 030220 oncology & carcinogenesis Liver biopsy Hepatocellular carcinoma 030211 gastroenterology & hepatology Female business Tomography X-Ray Computed |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 2219-2840 1007-9327 |
| Popis: | First reported in 1976, hepatic angiomyolipoma (HAML) is a rare mesenchymal liver tumor occurring mostly in middle-aged women. Diagnosis of the liver mass is often incidental on abdominal imaging due to the frequent absence of specific symptoms. Nearly 10% of HAMLs are associated with tuberous sclerosis complex. HAML contains variable proportions of blood vessels, smooth muscle cells and adipose tissue, which renders radiological diagnosis hazardous. Cells express positivity for HMB-45 and actin, thus these tumors are integrated into the group of perivascular epithelioid cell tumors. Typically, a HAML appears on magnetic resonance imaging (or computed tomography scan) as a hypervascular solid tumor with fatty areas and with washout, and can easily be misdiagnosed as other liver tumors, particularly hepatocellular carcinoma. The therapeutic strategy is not clearly defined, but surgical resection is indicated for symptomatic patients, for tumors showing an aggressive pattern (i.e., changes in size on imaging or high proliferation activity and atypical epithelioid pattern on liver biopsy), for large (> 5 cm) biopsy-proven HAML, and if doubts remain on imaging or histology. Conservative management may be justified in other conditions, since most cases follow a benign clinical course. In summary, the correct diagnosis of HAML is challenging on imaging and relies mainly on pathological findings. |
| Databáze: | OpenAIRE |
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