Gökhan GÜNGÖR, Ertugrul KAYACETİN, Murat BİYİK, Orhan OZBEK, Ramazan UCAR, Fusun BABA, Ali DEMİR

Giant Hepatic Angiomyolipoma Mimicking Hepatocellular Carcinoma

Anjiyomyolipomlar, tipik olarak böbrekte görülen ve karaciğerde çok nadir olan benign mezenkimal tümörlerdir. Bu tümörler görüntüleme teknikleri ile teşhis edilebilse de, tanı esas olarak patolojik bulgulara dayanır. Çünkü anjiyomyolipomlar radyolojik görüntülerde bazı özellikleri nedeniyle hepatoselüler karsinom gibi diğer karaciğer tümörlerini taklit edebilirler. Biz görüntüleme tekniklerinde hepatoselüler karsinomu taklit eden bir hepatik anjiyomyolipom vakasını sunduk. Radyolojik görüntülere göre hepatoselüler karsinomdan şüphe ettik, fakat biyopsi sonucu hepatik anjiyomyolipom idi. Bu tümörlerin malign transformasyon ve spontan rüptür gibi potansiyel riskleri vardır. Hepatik anjiyomyolipomların efektif tedavisi cerrahi rezeksiyondur

Anahtar Kelimeler:

Hepatik anjiyomyolipom, hepatoselüler karsinom, tedavi, takip

Giant Hepatic Angiomyolipoma Mimicking Hepatocellular Carcinoma

Angiomyolipomas (AMLs) are a benign mesenchymal tumor that typically occurs in the kidney and very rare in the liver. Even though these tumors can be diagnosed with imaging tecniques, diagnosis mainly relies on pathological findings. Because AMLs can mimic other hepatic tumors such as hepatocellular carcinoma (HCC) on radiologic images due to some of the features. We presented a giant hepatic AML case which mimicing hepatocellular carcinoma in imaging techniques. We suspected from hepatocellular carcinoma according to radiologic images, but biopsy result was hepatic angiomyolipoma. There are potential risks such as spontaneous rupture and malignant transformation of these tumors. The effective therapy of hepatic AML is surgical resection.

Keywords:

Hepatic angiomyolipoma, hepatocellular carcinoma, treatment, follow-up,

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1. Petrolla AA, Xin W. Hepatic angiomyolipoma. Arch Pathol Lab Med 2008;132(10):1679-82.
2. Kamimura K, Nomoto M, Aoyagi Y. Hepatic angiomyolipoma: diagnostic findings and management. Int J Hepatol 2012;2012:410781.
3. Li T, Wang L, Yu HH, et al. Hepatic angiomyolipoma: a retrospective study of 25 cases. Surg Today 2008;38(6):529- 35.
4. Ding GH, Liu Y, Wu MC, Yang GS, Yang JM, Cong WM. Diagnosis and treatment of hepatic angiomyolipoma. J Surg Oncol 2011;103(8):807-12.
5. Chang Z, Zhang JM, Ying JQ, Ge YP. Characteristics and treatment strategy of hepatic angiomyolipoma: a series of 94 patients collected from four institutions. J Gastrointestin Liver Dis 2011;20(1):65-9.
6. Krebs S, Esposito I, Lersch C, Gaa J, Schmid RM, Ebert O. Preoperative radiological characterization of hepatic angiomyolipoma using magnetic resonance imaging and contrast-enhanced ultrasonography: a case report. J Med Case Rep 2011 26;5:481
7. Makhlouf HR, Ishak KG, Shekar R, Sesterhenn IA, Young DY, Fanburg-Smith JC. Melanoma markers in angiomyolipoma of the liver and kidney: a comparative study. Arch Pathol Lab Med 2002;126:49–55.
8. Dalle I, Sciot R, de Vos R, et al. Malignant angiomyolipoma of the liver: A hitherto unreported variant. Histopathology 2000;36:443–50.
9. Mizuguchi T, Katsuramaki T, Nobuoka T, et al. Growth of hepatic angiomyolipoma indicating malignant potential. J Gastroenterol Hepatol 2004;19:1328–30.
10. Guidi G, Catalano O, Rotondo A. Spontaneous rupture of a hepatic angiomyolipoma: CT findings and literature review. Eur Radiol 1997;7:335–7.
11. Ukai K, Fuji A, Nishiwaki J, et al. Giant hepatic angiomyolipoma associated with disseminated intravascular coagulation. Intern Med 1997;36:186–90.
12. Kelleher T, Staunton M, Malone D, Geoghan J, Aiden McCormick P. Budd-Chiari syndrome associated with angiomyolipoma of the liver J Hepatol 2004;40:1041–9.
13. Ding GH, Liu Y, Wu MC, Yang GS, Yang JM, Cong WM. Diagnosis and treatment of hepatic angiomyolipoma. J Surg Oncol 2011;103(8):807-12.
14. Yang CY, Ho MC, Jeng YM, Hu RH, Wu YM, Lee PH. Management of hepatic angiomyolipoma. J Gastrointest Surg 2007; 11(4):452-7.