Park Andrew, Savsani Kush, Alfonso Anjelica, Jo Ester, Hatfield Bryce, Imai Daisuke, Khan Aamir, Sharma Amit, Saeed Irfan, Kumaran Vinay, Cotterell Adrian, Bruno David, Sambommatsu Yuzuru, Lee Seung
Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Department of Pathology, Virginia Commonwealth University Health System, Richmond, VA, USA.
Ann Hepatobiliary Pancreat Surg. 2024 Nov 30;28(4):527-534. doi: 10.14701/ahbps.24-033. Epub 2024 Jun 13.
Hepatic angiomyolipoma (HAML) is a rare, benign mesenchymal liver tumor encountered in Asia, primarily in females, and can be found within the right hepatic lobe, but also in other areas of the liver. Immunohistochemically, HAMLs are characteristically positive for human melanoma black-45 antigen (HMB-45) and can histochemically vary in the composition of angiomatous, lipomatous, and myomatous tissue, together with the presence of epithelioid cells. In this case report, we discuss a previously healthy patient presenting with bloating and previously documented concern of liver lesions, found to have HAML confirmed by surgical pathology. Surgery was decided, as HAMLs greater than 10 cm are at risk of rupture. This is one of the first documented cases of HAML resected through robot-assisted bisegmentectomy and cholecystectomy, and therefore, intraoperative images have been included to assist in the planning of future robotic cases.
肝血管平滑肌脂肪瘤(HAML)是一种罕见的良性间质性肝脏肿瘤,在亚洲较为常见,主要发生于女性,可出现在右肝叶,但也可见于肝脏的其他部位。免疫组织化学方面,HAML通常对人黑素瘤黑色45抗原(HMB - 45)呈阳性,组织化学上,其血管性、脂肪性和肌性组织的组成以及上皮样细胞的存在情况会有所不同。在本病例报告中,我们讨论了一名既往健康的患者,该患者出现腹胀且之前有肝脏病变的记录,经手术病理证实患有HAML。由于直径大于10 cm的HAML有破裂风险,因此决定进行手术。这是首批记录的通过机器人辅助双段切除术和胆囊切除术切除HAML的病例之一,所以纳入了术中图像以辅助未来机器人手术病例的规划。