Rare benign liver tumors that require differentiation from hepatocellular carcinoma: focus on diagnosis and treatment

Abstract

Background/Aim: Recently, an increase in the number of asymptomatic rare benign liver tumors (BLTs) has been reported during health checkups. It is di cult to determine the nature of partial rare BLTs and not easy to distinguish from malignant liver tumors. This study aimed to analysis clinical features, diagnosis, and treatment of rare BLTs to reduce misdiagnosis and provide reference for clinical practice.Methods: From January 2012 to January 2021, we treated 112 rare BLTs by hepatectomy, including 54 focal nodular hyperplasia, 14 hepatocellular adenoma, 28 hepatic angiomyolipoma, 3 hepatic granuloma, 2 in ammatory pseudotumor of the liver, 2 nodular regenerative hyperplasia, 2 hepatic lipoma, 1 solitary brous tumor of the liver, 1 hepatic schwannoma and 1 hepatic myelolipoma.Results: The majority of patients were middle-aged female and asymptomatic. Single tumors were dominant. The diagnostic accuracies of computed tomography (CT) and magnetic resonance imaging (MRI) were 32.5% and 44.2%, respectively. The majority of tumors were likely to be misdiagnosed as hepatocellular carcinoma (HCC) or di cult to distinguish from HCC. All patients underwent surgical treatment.Postoperative pathological and immunohistochemical examination can con rm the diagnosis. No patients without tumor recurrence or metastasis during follow up period.Conclusion: Altogether, the clinical symptoms of rare BLTs lack speci city, and their preoperative diagnosis largely depends on imaging examination, with a low diagnostic accuracy rate and high chances of misdiagnosis as HCC. Diagnosis is con rmed by pathological and immunohistochemical examination. Surgical resection for rare BLT is safe and effective, regular postoperative follow-up is necessary. 14), HAML (n = 28, including 12 epithelioid angiomyolipomas), hepatic granuloma (n = 3), in ammatory pseudotumor of the liver (IPL) (n = 2), nodular regenerative hyperplasia (NRH) (n = 2), hepatic lipoma (n = 2), solitary brous tumor of the liver (SFTL) (n = 1), hepatic schwannoma (n = 1), and hepatic myelolipoma (n = 1).Clinical data included age, sex, oral contraceptive use, chronic diseases, clinical symptoms, liver function, blood routine, coagulation function, tumor markers (alpha-fetoprotein [AFP], carbohydrate antigen [CA] 19 − 9, carbohydrate antigen 125, and carcinoembryonic antigen), imaging ndings, tumor number, size and location, preoperative diagnosis, operation method, results of operation, postoperative pathologic and immunohistochemical results, and postoperative follow-up.Excised tumoral specimens were xed in formalin and embedded in para n. Next, the specimens were stained with hematoxylin-eosin and histologically examined, and immunohistochemical examination was performed on other sections.

Bilateral adrenal giant medullary lipoma combined with disorders of sex development: a rare case report and literature review

“…Cytogenetic examination of adrenal myelolipoma has been reported with chromosome (3; 21) (q25; 11) translocation, which also suggests a true tumor ( 17 ). Some authors point out that adrenal myelolipoma often occurs in endocrine diseases or chronic wasting diseases, which may stimulate the differentiation of adrenal cortical mesenchymal cells into myelocytes or adipocytes ( 18 ). At present, the presence of bone tissue in myelolipoma is controversial, and most scholars state that bone tissue is metaplasia.…”

Development of a Reliable GADSAH Model for Differentiating AFP-negative Hepatic Benign and Malignant Occupying Lesions

“… 5 In contrast, hepatic benign occupying lesions (HBOL), such as hepatic hemangiomas, generally exhibit slow growth and often require mere observation or local intervention. 6 Therefore, an accurate differential diagnosis of hepatic occupying lesions is crucial for developing appropriate treatment plans and predicting prognosis.…”