Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 21, 2009; 15(23): 2930-2932
Published online Jun 21, 2009. doi: 10.3748/wjg.15.2930
A case of hepatic angiomyolipoma difficult to distinguish from hepatocellular carcinoma
Masahiro Takahara, Yasuhiro Miyake, Kazuyuki Matsumoto, Daisuke Kawai, Eisuke Kaji, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata
Masahiro Takahara, Kazuyuki Matsumoto, Daisuke Kawai, Eisuke Kaji, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata, Department of Internal Medicine, Mitoyo General Hospital, Kagawa 769-1695, Japan
Yasuhiro Miyake, Department of Molecular Hepatology and Department of Gastroenterology & Hepatology, University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Takahara M and Miyake Y wrote the paper; Matsumoto K, Kawai D, Kaji E, Toyokawa T, Nakatsu M and Ando M performed the patient’s care; Hirohata M supervised and approved the final manuscript.
Correspondence to: Yasuhiro Miyake, MD, Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama 700-8558, Japan. miyakeyasuhiro@hotmail.com
Telephone: +81-86-2357219
Fax: +81-86-2255991
Received: March 11, 2009
Revised: May 23, 2009
Accepted: May 30, 2009
Published online: June 21, 2009
Abstract

We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma.

Keywords: Adipose cell; Hepatic angiomyolipoma; Hepatocellular carcinoma; HMB-45; Smooth muscle cell