Chang Y C, Tsai H M, Chow N H
Department of Surgery, National Cheng Kung University Medical Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, Tainan 70428, Taiwan.
Hepatogastroenterology. 2001 Jan-Feb;48(37):253-5.
Angiomyolipoma is a rare lipomatous tumor in the liver. Definitive preoperative diagnosis is becoming easier by the use of ultrasonography, computed tomography, and magnetic resonance imaging techniques. Nonsurgical treatment has been advocated for its benign nature. However, recently we encountered one case of hepatic angiomyolipoma with two concomitant hepatocellular carcinomas on a hepatitis B carrier. Although his serum alpha-fetoprotein was normal, under the above impression these lesions were resected. The pathologic findings showed a typical angiomyolipoma and two well-differentiated hepatocellular carcinomas with marked fatty metamorphosis. This is the first report of angiomyolipoma with concomitant hepatocellular carcinomas in the literature. Nonsurgical treatment of angiomyolipoma in an endemic area for hepatocellular carcinoma should proceed with caution because cases of fat-rich minute hepatocellular carcinomas will make the diagnosis difficult.
血管平滑肌脂肪瘤是一种罕见的肝脏脂肪性肿瘤。通过使用超声、计算机断层扫描和磁共振成像技术，术前明确诊断正变得越来越容易。因其良性性质，一直提倡非手术治疗。然而，最近我们遇到一例乙肝携带者合并有两个肝细胞癌的肝脏血管平滑肌脂肪瘤病例。尽管他的血清甲胎蛋白正常，但基于上述判断，对这些病变进行了切除。病理结果显示为典型的血管平滑肌脂肪瘤和两个具有明显脂肪变性的高分化肝细胞癌。这是文献中关于血管平滑肌脂肪瘤合并肝细胞癌的首例报告。在肝细胞癌流行地区，对血管平滑肌脂肪瘤进行非手术治疗应谨慎，因为富含脂肪的微小肝细胞癌病例会使诊断困难。
