Preoperative diagnosis of angiomyolipoma of the liver

Abstract

We experienced a case of surgically proven hepatic angiomyolipoma, a rare primary benign lipomatous tumor, which was preoperatively diagnosed by defining of its characteristic histologic components and benign radiologic nature with various imaging modalities. It was the first case that full radiologic evaluation was taken and internal vascular proliferation was defined by using dynamic bolus computed tomography (CT) prior to angiography.

Hepatic angiomyolipoma: Is fat in the liver friend or foe?

“…This almost doubles the number of published cases with cross-sectional imaging from 12 to 20 and adds three new cases with magnetic resonance imaging (MRI) to a single case [2][3][4][5][6][7][8][9][10][11][12][13]. If one combines the data from these five papers, there is interesting new information both in the clinical and imaging arenas.…”

“…Larger lesions demonstrated the typical appearance of fat and large intratumoral vessels (the socalled "macroaneurysms") detected by MRI, post-enhanced CT, and potentially by color Doppler ultrasound. In smaller lesions (approximately less than 4 cm in size), the amount of fat contained in an AML may be too small to be detected by imaging, making small AMLs nonspecific lesions, apt for biopsy [2][3][4]. One can speculate if the lack of distinguishable fat is due to the small size of the tumor or the relatively small fat content compared to muscular and vascular components.…”

Angiomiolipoma de hígado: Un tumor hepático benigno poco frecuente

“…En la resonancia magnética (RM), el angiomiolipoma se comporta como una LOE de baja intensidad, excepto en las zonas grasas, donde la señal aparece como focos hiperintensos (6).…”

Angiomiolipoma epitelioide hepático

“…El AML se presenta en la TAC como una lesión bien definida y de baja densidad (-30 UH) con áreas de hipoatenuación más marcada que se corresponden con el componente graso del tumor. En la secuencia T1 de la resonancia magnética (RM) se comporta como una masa de baja intensidad de señal con focos hiperintensos que se corresponden con aquellas zonas grasas de mayor hipoatenuación en la TAC 8 . Con la técnica de supresión grasa (RM) esta área hipercaptante en T1 aparece hipointensa y tras la inyección de gadolinio en la RM las zonas más vascularizadas del tumor aparecen con hipercaptación importante y duradera 1,3,9,10 .…”