Malignant angiomyolipoma in the liver: A case report with pathological and molecular analysis

Malignant potential of hepatic angiomyolipoma: case report and literature review

“…N/A not applicable a Portal vein invasion was found in recurrent tumors was relatively smaller than that in the other 3 cases with portal vein thrombosis (mean 18.3 ± 7.5 cm) [9,14,15]. Our patient (Case 10 in Table 1) also showed strongly enhanced portal vein connecting from the tumor on angiography, suggesting significant tumor invasion and/or tumor thrombosis in the vein.…”

“…They also described in their report that one of the unique features of malignant hepatic AML is the clinical evidence of aggressive behavior, including metastasis or death [14]. Deng et al [15] reported a case of malignant AML which revealed recurrence of an 11 cm tumor and multiple metastases of the tumor in the residual liver and tail of the pancreas, 3 years after the resection of the primary tumor; 4 months after chemotherapy, multiple metastases appeared in the lung, resulting in a fatal course. A summary of these cases is shown in Table 1.…”

“…Misdiagnosis of this tumor has been focused on in various articles; however, since 2000, several reports have revealed that hepatic AMLs can become malignant, metastasize, enlarge, and recur [3,5,[8][9][10][11][12][13][14][15]. In 1989, Ohmori et al [8] reported the first possibly malignant case, which increased in size to 18 cm and caused liver dysfunction and bronchopneumonia with exacerbating hepatomegaly, resulting in the patient's death.…”

“…Although, as Nonomura et al [7] reported, 24 of 39 (62%) hepatic AMLs with an invasive growth pattern into the surrounding parenchyma and along the portal and hepatic veins showed no malignant behavior, there were more than 9 cases of AML which may have had malignant potential [3,[8][9][10][11][12][13][14][15]. Our further review of these nine cases revealed that although an invasive pattern was found in almost all cases, 3 of 4 cases (Cases 2, 6-8) [9,[13][14][15] which showed portal vein thrombosis had a significantly severe prognosis, with 75% mortality, caused by multiple recurrences and metastases in the liver (Cases 2, 7, 8), peritoneum (Cases 2, 7), retroperitoneal region (Case 7), gastrohepatic omentum (Case 7), pancreas (Case 8), and lung (Case 8) [9,14,15]. Case 2, which Dalle et al [9] reported, was followed up for 5 years, because it was diagnosed as AML by immunohistochemical analysis; however, its size increased from 15 to 26 cm in 5 years, and as a result, there were multiple metastases in the liver, which revealed portal vein thromboses.…”

Hepatic Angiomyolipomas: Ultrasonic Characteristics of 25 Patients from a Single Center

“…It is still difficult to distinguish hepatic AMLs from HCCs, especially in areas endemic for HCC, such as China. A history of cirrhosis and serum biomarkers may help to make the distinction between the two lesion types (Deng et al 2008;Nguyen et al 2008;Rouquie et al 2006;Parfitt et al 2006). Hepatic hemangioma could be excluded on CEUS by its features, that is, peripheral nodular hyper-enhancement during the arterial phase and gradual centripetal enhancement.…”