Wang F, Shi ZX, He XY, Han XJ, Wang JH, Yang JY, Cui LM. Hepatic epithelioid angiomyolipoma treated with laparoscopic resection and transcatheter arterial embolization first time: A case report and review of literature. World J Gastrointest Surg 2026; 18(1): 114050 [DOI: 10.4240/wjgs.v18.i1.114050]
Corresponding Author of This Article
Li-Ming Cui, MD, Department of Interventional Radiology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin 150001, Heilongjiang Province, China. limingcui1974@163.com
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Gastroenterology & Hepatology
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Case Report
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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/
Jan 27, 2026 (publication date) through Jan 28, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Wang F, Shi ZX, He XY, Han XJ, Wang JH, Yang JY, Cui LM. Hepatic epithelioid angiomyolipoma treated with laparoscopic resection and transcatheter arterial embolization first time: A case report and review of literature. World J Gastrointest Surg 2026; 18(1): 114050 [DOI: 10.4240/wjgs.v18.i1.114050]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 114050 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114050
Hepatic epithelioid angiomyolipoma treated with laparoscopic resection and transcatheter arterial embolization first time: A case report and review of literature
Fei Wang, Zhong-Xing Shi, Xin-Yu He, Xue-Jing Han, Jia-Hui Wang, Jia-Yi Yang, Li-Ming Cui, Department of Interventional Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Author contributions: Wang F participated in the collection of clinical data, patient follow-up; He XY collected the histopathological data; Han XJ, Wang JH, and Yang JY collected the imaging data; Wang F, He XY, Han XJ, Wang JH, and Yang JY contributed to writing the manuscript; Shi ZX and Cui LM jointly supervised the diagnosis and treatment of the patient.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ming Cui, MD, Department of Interventional Radiology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin 150001, Heilongjiang Province, China. limingcui1974@163.com
Received: September 10, 2025 Revised: September 30, 2025 Accepted: December 1, 2025 Published online: January 27, 2026 Processing time: 133 Days and 6.2 Hours
Abstract
BACKGROUND
Hepatic epithelioid angiomyolipoma (HEAML) is rare subtype of perivascular epithelioid cell tumor that is typically benign but has malignant potential. Misdiagnosis is common due to imaging similarities with other hypervascular hepatic neoplasms, such as hepatic hemangioma and hepatocellular carcinoma. An early biopsy should be considered when radiological findings raise suspicion of HEAML. A definitive diagnosis requires a histopathological assessment and immunohistochemical profile that confirm positivity for human melanoma black and smooth muscle actin and negativity for S-100.
CASE SUMMARY
This article presents a case of multifocal HEAML in a 37-year-old woman. Five years prior, abdominal ultrasound incidentally detected two hyperechoic lesions in the liver, which were initially diagnosed as hemangiomas and managed with routine imaging surveillance. At a recent follow-up, the progressive enlargement of both lesions was noted, and contrast-enhanced computed tomography raised the possibility of AML. The patient had a laparoscopic procedure to remove the tumor in the left liver lobe after the lesion progressed. Postoperative histopathological analysis confirmed the diagnosis of HEAML. Transarterial embolization was chosen as an alternative to surgical resection because of the high operative risk associated with the proximity of the right lobe lesion to the hepatic hilum. The patient had an uneventful recovery, and no recurrence was detected at follow-up.
CONCLUSION
Surgical resection combined with interventional embolization has proven effective for managing multifocal HEAML, a rare tumor with a high risk of misdiagnosis.
Core Tip: We report a case of multifocal hepatic epithelioid angiomyolipoma successfully managed with a multimodal approach combining laparoscopic resection and transarterial embolization. The predominant left lobe lesion was resected, while the high-risk hilar lesion was treated with minimally invasive transarterial embolization, interrupting arterial supply to achieve tumor control and preserve hepatic function. Follow-up showed uneventful recovery without recurrence. To the best of our knowledge, this is the first report highlighting the feasibility and therapeutic benefit of this combined strategy, providing a paradigm for the individualized management of multifocal hepatic epithelioid angiomyolipoma.
