Yang Ching-Yao, Ho Ming-Chih, Jeng Yung-Ming, Hu Rey-Heng, Wu Yao-Ming, Lee Po-Huang
Department of Surgery, National Taiwan University Hospital, and National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei, 100, Taiwan.
J Gastrointest Surg. 2007 Apr;11(4):452-7. doi: 10.1007/s11605-006-0037-3.
Preoperative diagnosis of hepatic angiomyolipoma is difficult, and the treatment for it remains controversial. The aim of this study is to review our experience in the treatment of hepatic angiomyolipoma and to propose a treatment strategy for this disease. We retrospectively collected the clinical, imaging, and pathological features of patients with hepatic angiomyolipoma. Immunohistochemical studies with antibodies for HMB-45, actin, S-100, cytokeratin, vimentin, and c-kit were performed. Treatment experience and long-term follow-up results are summarized. During a period of 9 years, 10 patients with hepatic angiomyolipoma were treated at our hospital. There was marked female predominance (nine patients). Nine patients received surgical resection without complications. One patient received nonoperative management with biopsy and follow-up. One patient died 11 months after surgery because of recurrent disease. We propose all symptomatic patients should receive surgical resection for hepatic angiomyolipoma. Conservative management with close follow-up is suggested in patients with asymptomatic tumors and meet the following criteria: (1) tumor size smaller than 5 cm, (2) angiomyolipoma proved through fine needle aspiration biopsy, (3) patients with good compliance, and (4) not a hepatitis virus carrier.
肝血管平滑肌脂肪瘤的术前诊断较为困难，其治疗方法仍存在争议。本研究的目的是回顾我们治疗肝血管平滑肌脂肪瘤的经验，并提出针对该疾病的治疗策略。我们回顾性收集了肝血管平滑肌脂肪瘤患者的临床、影像学和病理特征。采用抗HMB-45、肌动蛋白、S-100、细胞角蛋白、波形蛋白和c-kit抗体进行免疫组化研究。总结治疗经验和长期随访结果。在9年的时间里，我院共治疗了10例肝血管平滑肌脂肪瘤患者。女性明显居多（9例）。9例患者接受了手术切除，无并发症发生。1例患者接受了活检及随访的非手术治疗。1例患者术后11个月因疾病复发死亡。我们建议所有有症状的肝血管平滑肌脂肪瘤患者均应接受手术切除。对于无症状肿瘤且符合以下标准的患者，建议密切随访的保守治疗：（1）肿瘤大小小于5 cm；（2）经细针穿刺活检证实为血管平滑肌脂肪瘤；（3）患者依从性好；（4）非肝炎病毒携带者。
