Hepatic epithelioid angiomyolipoma treated with laparoscopic resection and transcatheter arterial embolization first time: A case report and review of literature

Figure 1 Ultrasound images. A: Initial ultrasound revealed a slightly hyperechoic hepatic mass measuring approximately 71 mm × 49 mm in the left lobe; B: A second slightly hyperechoic mass measuring approximately 33 mm × 32 mm was detected in the right lobe.

Figure 2 Computed tomography and contrast-enhanced computed tomography images. A and B: Hypodense lesions located in segments S3 and S7 of the liver, measuring approximately 61 mm × 44 mm and 33 mm × 27 mm, respectively, with heterogeneous density; C and D: During the arterial phase, both lesions demonstrated marked and heterogeneous enhancement with visible intratumoral vasculature; E and F: In the portal venous phase, the lesions showed reduced enhancement and appeared isodense relative to the surrounding parenchyma.

Figure 3 Histopathological features of hepatic epithelioid angiomyolipoma. A: Hematoxylin and eosin staining showed numerous epithelioid cells with eosinophilic cytoplasm and pleomorphic nuclei, accompanied by vascular stroma and a small amount of mature adipose tissue (100 ×); B: Immunohistochemical staining demonstrated strong diffuse positivity for melanoma antigen recognized by T cells 1 in tumor cells (100 ×); C: Immunohistochemical staining demonstrated strong diffuse positivity for human melanoma black in tumor cells (100 ×); D: Immunohistochemical staining demonstrated strong diffuse positivity for smooth muscle actin in tumor cells (100 ×).

Figure 4 Angiographic findings during transarterial embolization. A: Angiography performed with a 5F RH catheter revealed satisfactory portal venous return, with clear visualization of intratumoral vasculature and tumor blush; B: Superselective angiography via microcatheter following lipiodol infusion; C: Post-embolization angiography showed complete disappearance of tumor staining, indicating successful embolization.

Figure 5 Postoperative contrast-enhanced computed tomography images (arterial phase). A: Partial resection of the left hepatic lobe with a localized cystic hypodense region at the surgical site; B: The lesion in segment S7 exhibited marked heterogeneous enhancement and a decrease in size to approximately 27 mm.