Yan Shuyue, Wang Xuedong, Yu Xiangrong
Department of Radiology, Zhuhai Clinical Medical College of Jinan University (Zhuhai People's Hospital), Jinan University, Zhuhai, China.
J Gastrointest Oncol. 2025 Jun 30;16(3):1331-1338. doi: 10.21037/jgo-24-837. Epub 2025 Jun 16.
Hepatic epithelioid angiomyolipoma (HEAML) is a rare mesenchymal neoplasm that can occasionally exhibit malignant behavior, such as postoperative recurrence or distant metastasis. Most HEAML patients are female, and it is difficult to distinguish them from other liver tumors. The diagnostic accuracy rate is less than 32%. We present a case of HEAML in an elderly woman with mild fatty liver, without a history of hepatitis, tuberculosis. The patient underwent early laparoscopic liver tumor resection.
A 69-year-old woman presented with intermittent right upper abdominal discomfort. Imaging revealed an ovoid liver mass. She was in good overall health, with no history of chronic diseases, hepatitis, tuberculosis, allergies, surgeries, trauma, or blood transfusions. Laboratory tests were normal, with negative results for carcinoembryonic antigen and alpha-fetoprotein (AFP). After computed tomography (CT) and magnetic resonance imaging (MRI) examinations, the patient underwent laparoscopic liver tumor resection.
HEAML, the rare tumor, with a degree of malignant potential, predominantly affects elderly women. Certain characteristics on CT and MRI facilitate its differentiation from other intrahepatic lesions. In our case, a multimodal approach was utilized, and detailed imaging analysis of the tumor may serve as a reference for its accurate diagnosis.
肝上皮样血管平滑肌脂肪瘤（HEAML）是一种罕见的间叶性肿瘤，偶尔可表现出恶性行为，如术后复发或远处转移。大多数HEAML患者为女性，且难以将其与其他肝脏肿瘤区分开来。诊断准确率低于32%。我们报告一例老年女性HEAML病例，该患者有轻度脂肪肝，无肝炎、结核病史。患者接受了早期腹腔镜肝肿瘤切除术。
一名69岁女性出现间歇性右上腹不适。影像学检查发现肝脏有一个椭圆形肿块。她整体健康状况良好，无慢性疾病、肝炎、结核、过敏、手术、外伤或输血史。实验室检查正常，癌胚抗原和甲胎蛋白（AFP）结果均为阴性。经过计算机断层扫描（CT）和磁共振成像（MRI）检查后，患者接受了腹腔镜肝肿瘤切除术。
HEAML这种罕见肿瘤具有一定程度的恶性潜能，主要影响老年女性。CT和MRI上的某些特征有助于其与其他肝内病变相鉴别。在我们的病例中，采用了多模式方法，对肿瘤进行详细的影像学分析可为其准确诊断提供参考。
