Hepatic epithelioid angiomyolipoma is a rare and potentially severe but treatable tumor: A report of three cases and review of the literature

LIU, WENTAO; Meng, Zihui; Liu, Hongyu; Li, Wei; Wu, Qiong; ZHANG, XUEWEN; Changyong, E

doi:10.3892/ol.2016.4443

Cited by 17 publications

(18 citation statements)

References 26 publications

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“…FNH and HCC. In a previous study, the average onset age of HEAML was ~51 years ( 7 ), while the average age was 56 years in another study ( 12 ). We believed this difference was due to the divergence of cases and the small sample size.…”

Section: Discussionmentioning

confidence: 91%

Differentiating Hepatic Epithelioid Angiomyolipoma From Hepatocellular Carcinoma and Focal Nodular Hyperplasia via Radiomics Models

et al. 2020

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Background: We conduct a study in developing and validating two radiomics-based models to preoperatively distinguish hepatic epithelioid angiomyolipoma (HEAML) from hepatic carcinoma (HCC) as well as focal nodular hyperplasia (FNH). Methods: Totally, preoperative contrast-enhanced computed tomography (CT) data of 170 patients and preoperative contrast-enhanced magnetic resonance imaging (MRI) data of 137 patients were enrolled in this study. Quantitative texture features and wavelet features were extracted from the regions of interest (ROIs) of each patient imaging data. Then two radiomics signatures were constructed based on CT and MRI radiomics features, respectively, using the random forest (RF) algorithm. By integrating radiomics signatures with clinical characteristics, two radiomics-based fusion models were established through multivariate linear regression and 10-fold cross-validation. Finally, two diagnostic nomograms were built to facilitate the clinical application of the fusion models. Results: The radiomics signatures based on the RF algorithm achieved the optimal predictive performance in both CT and MRI data. The area under the receiver operating characteristic curves (AUCs) reached 0.996, 0.879, 0.999, and 0.925 for the training as well as test cohort from CT and MRI data, respectively. Then, two fusion models simultaneously integrated clinical characteristics achieved average AUCs of 0.966 (CT data) and 0.971 (MRI data) with 10-fold cross-validation. Through decision curve analysis, the fusion models were proved to be excellent models to distinguish HEAML from HCC and FNH in comparison between the clinical models and radiomics signatures. Conclusions: Two radiomics-based models derived from CT and MRI images, respectively, performed well in distinguishing HEAML from HCC and FNH and might be potential diagnostic tools to formulate individualized treatment strategies.

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Section: Discussionmentioning

confidence: 91%

Differentiating Hepatic Epithelioid Angiomyolipoma From Hepatocellular Carcinoma and Focal Nodular Hyperplasia via Radiomics Models

et al. 2020

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“…In a collective review of 24 patients with hepatic angiomyolipoma, the mean age of the patients was 47 ± 15 years, and 17 patients were female; in that study, four patients exhibited multiple hepatic lesions, and three patients had been previously diagnosed with tuberous sclerosis. The tumour diameters of the patients with single lesions varied from 2.8 to 32.0 cm.…”

Section: Discussionmentioning

confidence: 93%

Clinico‐pathological correlation of hepatic angiomyolipoma: a series of 23 resection cases

Jung

Hwang

Hong

et al. 2017

ANZ Journal of Surgery

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Background: Angiomyolipomas are rare neoplasms of mesenchymal origin and are derived from perivascular epithelioid cells. They usually develop in the kidney and rarely in the liver. Due to their rarity, most hepatic angiomyolipomas have been misinterpreted as hepatocellular carcinoma (HCC) or other hypervascular liver tumours on imaging studies. We aimed to assess the clinico-pathological correlation of hepatic angiomyolipoma. Methods: We identified 23 patients with hepatic angiomyolipoma through an institutional database search. Results: Of 5680 cases of primary liver tumours, 23 (0.4%) had angiomyolipomas (mean age, 43.6 AE 12.4 years; 16 female patients). Hepatitis B virus infection was noted in four patients, whereas a liver mass was incidentally detected on routine health screening in 13 patients. The preoperative diagnoses, before liver biopsy, included HCC in 14, angiomyolipoma in six, focal nodular hyperplasia in two and hepatic adenoma in one patient. Eventually, the preoperative diagnoses were changed to HCC in 12 and hepatic angiomyolipoma in 11 patients. The tumour size was 5.3 AE 4.6 cm, and 22 patients had a single tumour. All tumours exhibited positive findings for human melanoma black-45 and smooth muscle actin staining. During a follow-up period of 52.2 AE 23.7 months, none of the patients exhibited tumour recurrence or mortality. Conclusions: Hepatic angiomyolipoma is a rare form of primary liver tumour and is often misdiagnosed as other hypervascular tumours. Although angiomyolipoma is benign in nature, it also has malignant potential; hence, resection is indicated if the tumour grows or malignancy cannot be excluded. Surgical resection is a definitive curative treatment of hepatic angiomyolipoma.

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“…After the first description of Yamasaki et al [2] in 2000, 97 cases of hepatic EAML was reported [1,3,6,7,10-13]. The results are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 96%

“…The diagnosis of AML depends on immunohistochemical expression of melanocytic markers HMB45 and MelanA. Myomatous spindle cells also express muscle specific antigen [1,3,5,7]. EAML is a variant of AML, that consists of predominantly epithelioid cells.…”

Section: Discussionmentioning

confidence: 99%

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Epithelioid angiomyolipoma of the liver: a case report

Lee

Kim

2017

Clin Mol Hepatol

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Epithelioid angiomyolipoma (EAML) of liver is a rare neoplasm. Hepatic EAML is often misdiagnosed as other neoplasms such as hepatocellular carcinoma due to non-specific clinical and radiologic features. The morphologic features under microscope and immunohistochemistry staining profile are important in the diagnosis EAML. Here, we report a case of 52-year-old man who found 1.2 cm mass in liver by routine checkup. On the impression of hepatocellular carcinoma, lateral sectionectomy of the liver was done. Microscopically, the tumor is composed of predominant epithelioid cells with vascular component and foamy cells. These cells were positive for HMB45, MelanA, and smooth muscle actin and negative for epithelial membrane antigen. The final diagnosis was hepatic EAML.

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Hepatic epithelioid angiomyolipoma is a rare and potentially severe but treatable tumor: A report of three cases and review of the literature

Cited by 17 publications

References 26 publications

Differentiating Hepatic Epithelioid Angiomyolipoma From Hepatocellular Carcinoma and Focal Nodular Hyperplasia via Radiomics Models

Differentiating Hepatic Epithelioid Angiomyolipoma From Hepatocellular Carcinoma and Focal Nodular Hyperplasia via Radiomics Models

Clinico‐pathological correlation of hepatic angiomyolipoma: a series of 23 resection cases

Epithelioid angiomyolipoma of the liver: a case report

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