Hepatic angiomyolipoma presenting with chronic epigastric pain: A case report

Abstract

Introduction: Angiomyolipomas primarily arising from the liver are rare. Hepatic angiomyolipoma (HAML) is a rare tumor characterized by the presence of blood vessels, muscle tissue and adipose tissue with only about 300 reported cases to date. This is the first case reported in literature of a Filipino patient. Case Report: A 49-year-old Filipino female presented with a two-year history of recurrent epigastric pain. Abdominal magnetic resonance imaging revealed a fat-containing lesion in the left liver lobe. Serial follow-up revealed progressive enlargement on imaging studies. Serologic tests were negative for malignancy or infection. The patient underwent left hepatic lateral segmentectomy which revealed a 7.5x7 cm friable mass involving hepatic segments II and III. Histopathology showed mature fat cells with a few thick-walled blood vessels and spindled smooth muscle cells with no atypia. Homatropine methylbromide-45 test showed strong and diffused staining confirming angiomyolipoma. Conclusion: Clinical evaluation and a comprehensive analysis of ultrasonography, Anthony Relucio Perez1, Clarence Yacapin2 Affiliations: 1MD, MHA, Vice Chair for Training, Department of Surgery, UP College of Medicine and Philippine General Hospital, Section Chief, Hepatobiliary and Pancreatic Surgery Asian Hospital and Medical Center; 2MD, Clinical Fellow Section of Minimally Invasive Surgery, Department of Surgery Asian Hospital and Medical Center. Corresponding Author: Anthony Relucio Perez, 108 Dayap Street Ayala Alabang, Muntinlupa, NCR, Philippines, 1780; Email: tonyperez92@yahoo.com Received: 26 June 2017 Accepted: 26 July 2017 Published: 21 August 2017 computed tomography scan and magnetic resonance imaging scan are essential for correct preoperative diagnosis. Symptoms, malignant potential and inability to distinguish from liver malignancies may indicate surgical resection as the best treatment option.