Clinical characteristics and outcomes of patients with hepatic angiomyolipoma: A literature review

Figure 1 The Hematoxylin-Eosin-Saffron staining image of hepatic angiomyolipoma. There are three components of hepatic angiomyolipoma: vessel (*), adipocytes (**) and numerous epithelioid cells (***). There are fewer hepatocytes (†) (magnification × 10).

Figure 2 Angiomyolipoma in a healthy 33-year-old woman. Abdominal computed tomography on arterial phase showed a hypervascular solid tumor localized in the right posterior segment (arrowheads).

Figure 3 T1 weighted magnetic resonance images. Signal dropout at the periphery of the lesion due to fat contingents (arrowhead). A: In-phase; B: Opposed-phase.

Figure 4 T1 weighted images one hour after hepatocyte-specific agent injection (gadobenate dimeglumine). Hyposignal of the lesion indicates that this is not a hepatocytic tumor.

Figure 5 Management algorithm for suspected hepatic angiomyolipoma on imaging. ¹Hepatic angiomyolipoma diagnosis is suggested in the presence of fatty tissue within the solid lesion or presence of wash-out. In the presence of tumor-related symptoms, surgical resection is considered first. ²Features suggesting malignant potential are reported in Table 2. Some authors also recommend surgery in the case of epithelioid-type hepatic angiomyolipoma, which would be at greater risk of progression. Likewise, an association with tuberous sclerosis complex is a condition that increases the risk of malignant transformation, by analogy with renal angiomyolipoma[3]. ³Monitoring maintained despite the benign nature of the initial diagnosis because the aggressive behavior of the tumor is difficult to predict. ⁴Other possible therapeutic options include mTOR inhibitors, radiofrequency ablation, arterial embolization in cases of hemorrhagic rupture, and liver transplantation. Citation: Klompenhouwer AJ, Verver D, Janki S, Bramer WM, Doukas M, Dwarkasing RS, de Man RA, IJzermans JNM. Management of hepatic angiomyolipoma: A systematic review. Liver Int 2017; 37(9): 1272-1280. Copyright ©The Author(s) 2017. Published by John Wiley and Sons[3]. MRI: Magnetic resonance imaging; CT: Computed tomography.