Department of Abdominal Surgery, Zhejiang Cancer Hospital, Hangzhou, China.
J Gastroenterol Hepatol. 2013 Oct;28(10):1648-53. doi: 10.1111/jgh.12289.
Hepatic angiomyolipoma (AML) is a rare, hepatic mesenchymal neoplasm. Its preoperative diagnosis is very difficult, and the treatment is still controversial. The aim is to summarize experience in diagnosis and management of hepatic AML from a cancer center.
We retrospectively reviewed the clinical presentation, histopathological, features and treatment of the tumors encountered at our institute from January 2000 to December 2012.
The patients included six females and two males, with female preponderance. Six patients are asymptomatic. Laboratory tests lack specificity. Combining imaging modality, only one patient obtained the accurate diagnosis of hepatic AML and was confirmed by fine-needle aspiration biopsy combined with homatropine methylbromide-45 staining. All other patients received hepatic resection. There was no tumor recurrence or increase of tumor size within the follow-up period.
We suggest fine-needle aspiration combined with homatropine methylbromide-45 staining should be performed in all patients who are asymptomatic and without serological abnormalities. Surgical resection might be considered only if the malignant potential of the lesion cannot be ruled out or the tumor size is increasing during observation.
肝血管平滑肌脂肪瘤（AML）是一种罕见的肝间叶性肿瘤。其术前诊断非常困难，治疗仍存在争议。本研究旨在总结癌症中心在肝 AML 的诊断和治疗方面的经验。
回顾性分析我院 2000 年 1 月至 2012 年 12 月期间收治的肝 AML 患者的临床表现、组织病理学特征和治疗方法。
患者包括 6 例女性和 2 例男性，女性多见。6 例患者无症状。实验室检查缺乏特异性。结合影像学检查，仅 1 例患者获得肝 AML 的准确诊断，并经细针穿刺活检结合毛果芸香碱-45 染色证实。其余所有患者均接受了肝切除术。随访期间无肿瘤复发或肿瘤大小增加。
对于无症状且无血清学异常的患者，建议行细针穿刺活检联合毛果芸香碱-45 染色。只有当病变的恶性潜能不能排除或在观察期间肿瘤大小增大时，才考虑手术切除。
