Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3414-3419
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3414
Hepatocellular carcinoma with concomitant hepatic angiomyolipoma and cavernous hemangioma in one patient
Xiao-Wen Ge, Hai-Ying Zeng, Akesu Su-Jie, Min Du, Yuan Ji, Yun-Shan Tan, Ying-Yong Hou, Jian-Fang Xu
Xiao-Wen Ge, Hai-Ying Zeng, Akesu Su-Jie, Min Du, Yuan Ji, Yun-Shan Tan, Ying-Yong Hou, Jian-Fang Xu, Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Author contributions: Ge XW and Xu JF made the pathological diagnosis of this case; Zeng HY, Su-Jie A and Du M contributed analytic tools; and Ge XW, Ji Y, Tan YS, Hou YY and Xu JF wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jian-Fang Xu, MD, Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai 200032, China. jianfangxu01@hotmail.com
Telephone: +86-21-64041990 Fax: +86-21-64038472
Received: August 8, 2014
Peer-review started: August 8, 2014
First decision: September 27, 2014
Revised: October 27, 2014
Accepted: December 1, 2014
Article in press: December 1, 2014
Published online: March 21, 2015
Processing time: 225 Days and 5.3 Hours
Abstract

The risk of developing hepatocellular carcinoma (HCC) is strongly associated with hepatitis B virus infection. Hepatic angiomyolipoma (AML), a rare benign tumor, is composed of a heterogeneous mixture of adipose cells, smooth muscle cells and blood vessels. Here, we report the case of a 44-year-old man who developed HCC with a concomitant hepatic AML and a cavernous hemangioma, in the absence of cirrhosis. To our knowledge, based on an extensive literature search using the www.pubmed.gov website, this is the first report of an HCC case with both concomitant AML and cavernous hemangioma at the same position in the liver. The presence of the hepatitis B surface antigen was detected, but the liver function was normal. Clinical and pathological data were collected before and during the treatment. Hepatic AML was diagnosed based on the typical histological characteristics and immunohistochemical staining, which revealed, a positive staining with a melanocytic cell-specific monoclonal antibody. There was no evidence of tuberous sclerosis complex in this patient. Although the HCC was poor- to moderately-differentiated, the characteristics of the AML and the cavernous hemangioma in this patient did not match any criteria for malignancy. Hepatectomy followed by transarterial chemoembolization treatment were effective therapeutic methods for the adjacent lesions in this patient. This case is an interesting coincidence.

Keywords: Angiomyolipoma; Hepatocellular carcinoma; Cavernous hemangioma; Hepatitis B virus infection; Concomitant

Core tip: Hepatic angiomyolipoma (AML) is a benign tumor which is composed of a heterogeneous mixture of adipose cells, smooth muscle cells and blood vessels. Here, we report the case of a 44-year-old man who developed Hepatocellular carcinoma (HCC) with concomitant hepatic AML and cavernous hemangioma, in the absence of cirrhosis. To our knowledge, based on an extensive literature search using the PubMed, this is the first report of an HCC case with both concomitant AML and cavernous hemangioma in the liver. The characteristics of the AML and cavernous hemangioma in this patient did not match any criteria for malignancy.