Unusual Finding of a Hepatic Angiomyolipoma Mimicking a Hepatocellular Carcinoma

Introduction

Hepatic angiomyolipoma (HAML) is a rare, usually btenign liver tumor consisting of various amounts of blood vessels, smooth muscle, and adipose cells which leads to a large spectrum of possible imaging features (Kamimura K. Int J Hepatol. 2012; 2012: 410 781), making its correct radiological diagnosis and especially its differentiation from hepatocellular carcinoma (HCC) difficult, which could lead to excessive surgical treatment including even liver transplantation (Klompenhouwer AJ. HPB (Oxford). 2020 Apr; 22(4): 622–629).

Although the liver is the second most common site of angiomyolipoma (AML), with the kidney being the first, HAML is quite rare with an estimation of around 600 cases reported in the literature according to the most recent available systematic review (Klompenhouwer AJ. Liver Int. 2017 Sep; 37(9): 1272–1280). It is female-predominant (with an estimated male-to-female ratio of 1:3), occurs in young adults (age 24–53), is usually asymptomatic, and is rarely related to the tuberous sclerosis complex (TSC) (in around 10 % of cases, as opposed to the renal AML with up to half of cases occurring in the setting of TSC), and it is usually solitary and more frequent in the right liver lobe (Klompenhouwer AJ. Liver Int. 2017 Sep; 37(9): 1272–1280).

We report a case of a young female with a rare finding of an HAML in the left liver lobe, initially thought to be an HCC in a non-cirrhotic liver.

Publication History

Article published online:
13 April 2023