Download PDF
Digestive Disease Interventions 2023; 07(03): 202-222
DOI: 10.1055/s-0043-1762923
Review Article

Minimally Invasive Image-Guided Procedures for Benign Liver Lesions

Fiza M. Khan
1   Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Nariman Nezami
2   Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
3   Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland
,
Florian Stumpf
4   University of Maryland School of Medicine, Baltimore, Maryland
,
Tyler A. Smith
5   Department of Radiology and Imaging Sciences, Division of Interventional Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Margarita Revizin
6   Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
,
Adam Fang
2   Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
,
Mohammad F. Loya
1   Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Rahul A. Sheth
7   Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
,
Steven Yevich
7   Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
,
Peiman Habibillahi
7   Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

As access to affordable high-resolution medical imaging has improved, so too has the identification of benign hepatic lesions. Advanced imaging techniques and applications often allow characterization of these lesions so as to differentiate benign and malignant lesions without the need for biopsy. Patients with benign liver lesions are usually asymptomatic; however, a palliative intervention may be indicated if a benign liver lesion is symptomatic. This article reviews the characteristic imaging features of benign liver lesions, the indications for minimally invasive intervention, and the specific procedures for minimally invasive, nonsurgical intervention, and the procedural expectations, effectiveness, and periprocedural care.

Keywords

hemangioma - focal nodular hyperplasia - hepatic adenoma


Publication History

Received: 14 June 2022

Accepted: 14 December 2022

Article published online:
05 May 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Adnan A, Sheth RA. Image-guided percutaneous biopsy of the liver. Tech Vasc Interv Radiol 2021; 24 (04) 100773
    CrossrefPubMedGoogle Scholar
  • 2 Midia M, Odedra D, Shuster A, Midia R, Muir J. Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol 2019; 25 (01) 71-80
    CrossrefPubMedGoogle Scholar
  • 3 Honar N, Jooya P, Haghighat M. et al. Complications of blind versus ultrasound-guided percutaneous liver biopsy in children. Arab J Gastroenterol 2015; 16 (3-4): 90-93
    CrossrefPubMedGoogle Scholar
  • 4 Fioole B, Kokke M, van Hillegersberg R, Rinkes IH. Adequate symptom relief justifies hepatic resection for benign disease. BMC Surg 2005; 5: 7
    CrossrefPubMedGoogle Scholar
  • 5 Koffron AJ, Auffenberg G, Kung R, Abecassis M. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 2007; 246 (03) 385-392 , discussion 392–394
    CrossrefPubMedGoogle Scholar
  • 6 Bean WJ, Rodan BA. Hepatic cysts: treatment with alcohol. AJR Am J Roentgenol 1985; 144 (02) 237-241
    CrossrefPubMedGoogle Scholar
  • 7 Andersson R, Jeppsson B, Lunderquist A, Bengmark S. Alcohol sclerotherapy of non-parasitic cysts of the liver. Br J Surg 1989; 76 (03) 254-255
    CrossrefPubMedGoogle Scholar
  • 8 vanSonnenberg E, Wroblicka JT, D'Agostino HB. et al. Symptomatic hepatic cysts: percutaneous drainage and sclerosis. Radiology 1994; 190 (02) 387-392
    CrossrefPubMedGoogle Scholar
  • 9 Kairaluoma MI, Leinonen A, Ståhlberg M, Päivänsalo M, Kiviniemi H, Siniluoto T. Percutaneous aspiration and alcohol sclerotherapy for symptomatic hepatic cysts. An alternative to surgical intervention. Ann Surg 1989; 210 (02) 208-215
    CrossrefPubMedGoogle Scholar
  • 10 Simonetti G, Profili S, Sergiacomi GL, Meloni GB, Orlacchio A. Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy. Cardiovasc Intervent Radiol 1993; 16 (02) 81-84
    CrossrefPubMedGoogle Scholar
  • 11 Montorsi M, Torzilli G, Fumagalli U. et al. Percutaneous alcohol sclerotherapy of simple hepatic cysts. Results from a multicentre survey in Italy. HPB Surg 1994; 8 (02) 89-94
    CrossrefPubMedGoogle Scholar
  • 12 Tikkakoski T, Mäkelä JT, Leinonen S. et al. Treatment of symptomatic congenital hepatic cysts with single-session percutaneous drainage and ethanol sclerosis: technique and outcome. J Vasc Interv Radiol 1996; 7 (02) 235-239
    CrossrefPubMedGoogle Scholar
  • 13 Larssen TB, Rosendahl K, Horn A, Jensen DK, Rørvik J. Single-session alcohol sclerotherapy in symptomatic benign hepatic cysts performed with a time of exposure to alcohol of 10 min: initial results. Eur Radiol 2003; 13 (12) 2627-2632
    CrossrefPubMedGoogle Scholar
  • 14 Iannuccilli JD, Dupuy DE. How to set up a successful tumor ablation practice. Tech Vasc Interv Radiol 2013; 16 (04) 201-208
    CrossrefPubMedGoogle Scholar
  • 15 Knavel EM, Brace CL. Tumor ablation: common modalities and general practices. Tech Vasc Interv Radiol 2013; 16 (04) 192-200
    CrossrefPubMedGoogle Scholar
  • 16 Cheng D, Amin P, Ha TV. Percutaneous sclerotherapy of cystic lesions. Semin Intervent Radiol 2012; 29 (04) 295-300
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Wu S, Gao R, Yin T. et al. Complications of radiofrequency ablation for hepatic hemangioma: a multicenter retrospective analysis on 291 cases. Front Oncol 2021; 11: 706619
    CrossrefPubMedGoogle Scholar
  • 18 Lai EC, Wong J. Symptomatic nonparasitic cysts of the liver. World J Surg 1990; 14 (04) 452-456
    CrossrefPubMedGoogle Scholar
  • 19 Pitale A, Bohra AK, Diamond T. Management of symptomatic liver cysts. Ulster Med J 2002; 71 (02) 106-110
    PubMedGoogle Scholar
  • 20 Mavilia MG, Pakala T, Molina M, Wu GY. Differentiating cystic liver lesions: a review of imaging modalities, diagnosis and management. J Clin Transl Hepatol 2018; 6 (02) 208-216
    CrossrefPubMedGoogle Scholar
  • 21 Kim JY, Kim SH, Eun HW. et al. Differentiation between biliary cystic neoplasms and simple cysts of the liver: accuracy of CT. AJR Am J Roentgenol 2010; 195 (05) 1142-1148
    CrossrefPubMedGoogle Scholar
  • 22 Aoki T, Kato T, Yasuda D. et al. Cyst wall resection and ablation by hand-assisted laparoscopic surgery combined with argon plasma coagulator for huge hepatic cysts. Int Surg 2007; 92 (06) 361-366
    PubMedGoogle Scholar
  • 23 Kwon AH, Matsui Y, Inui H, Imamura A, Kamiyama Y. Laparoscopic treatment using an argon beam coagulator for nonparasitic liver cysts. Am J Surg 2003; 185 (03) 273-277
    CrossrefPubMedGoogle Scholar
  • 24 Wahba R, Kleinert R, Prenzel K, Bangard C, Hölscher AH, Stippel DL. Laparoscopic deroofing of nonparasitic liver cysts with or without greater omentum flap. Surg Laparosc Endosc Percutan Tech 2011; 21 (01) 54-58
    CrossrefPubMedGoogle Scholar
  • 25 Moorthy K, Mihssin N, Houghton PW. The management of simple hepatic cysts: sclerotherapy or laparoscopic fenestration. Ann R Coll Surg Engl 2001; 83 (06) 409-414
    PubMedGoogle Scholar
  • 26 Furumaya A, van Rosmalen BV, de Graeff JJ. et al; Dutch Benign Liver Tumor Group. Systematic review on percutaneous aspiration and sclerotherapy versus surgery in symptomatic simple hepatic cysts. HPB (Oxford) 2021; 23 (01) 11-24
    CrossrefPubMedGoogle Scholar
  • 27 Halvorsen RA, Korobkin M, Foster WL, Silverman PM, Thompson WM. The variable CT appearance of hepatic abscesses. AJR Am J Roentgenol 1984; 142 (05) 941-946
    CrossrefPubMedGoogle Scholar
  • 28 Lissandrin R, Tamarozzi F, Mariconti M, Manciulli T, Brunetti E, Vola A. Watch and wait approach for inactive echinococcal cyst of the liver: an update. Am J Trop Med Hyg 2018; 99 (02) 375-379
    CrossrefPubMedGoogle Scholar
  • 29 Kuo SH, Lee YT, Li CR. et al. Mortality in Emergency Department Sepsis score as a prognostic indicator in patients with pyogenic liver abscess. Am J Emerg Med 2013; 31 (06) 916-921
    CrossrefPubMedGoogle Scholar
  • 30 Lardière-Deguelte S, Ragot E, Amroun K. et al. Hepatic abscess: diagnosis and management. J Visc Surg 2015; 152 (04) 231-243
    CrossrefPubMedGoogle Scholar
  • 31 Stojkovic M, Rosenberger K, Kauczor HU, Junghanss T, Hosch W. Diagnosing and staging of cystic echinococcosis: How do CT and MRI perform in comparison to ultrasound?. PLoS Negl Trop Dis 2012; 6 (10) e1880
    CrossrefPubMedGoogle Scholar
  • 32 Richter J, Lindner AK, Geisel D. et al. Treatment of a giant hepatic echinococcal cyst with percutaneous drainage and in vivo assessment of the protoscolicidal effect of praziquantel. Clin J Gastroenterol 2021; 14 (03) 888-892
    CrossrefPubMedGoogle Scholar
  • 33 Toro A, Mahfouz AE, Ardiri A. et al. What is changing in indications and treatment of hepatic hemangiomas. A review. Ann Hepatol 2014; 13 (04) 327-339
    CrossrefPubMedGoogle Scholar
  • 34 Yoon SS, Charny CK, Fong Y. et al. Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma. J Am Coll Surg 2003; 197 (03) 392-402
    CrossrefPubMedGoogle Scholar
  • 35 Vilgrain V, Zappa M, Hakimé A, Sibert A, Vullierme MP. [Liver imaging: pitfalls, pseudolesions and pseudotumors]. J Radiol 2007; 88 (7-8, Pt 2): 1104-1120
    PubMedGoogle Scholar
  • 36 Kuefner MA, Brand M, Ehrlich J, Braga L, Uder M, Semelka RC. Effect of antioxidants on X-ray-induced γ-H2AX foci in human blood lymphocytes: preliminary observations. Radiology 2012; 264 (01) 59-67
    CrossrefPubMedGoogle Scholar
  • 37 Concejero AM, Chen CL, Chen TY, Eng HL, Kuo FY. Giant cavernous hemangioma of the liver with coagulopathy: adult Kasabach-Merritt syndrome. Surgery 2009; 145 (02) 245-247
    CrossrefPubMedGoogle Scholar
  • 38 Belghiti J, Cauchy F, Paradis V, Vilgrain V. Diagnosis and management of solid benign liver lesions. Nat Rev Gastroenterol Hepatol 2014; 11 (12) 737-749
    CrossrefPubMedGoogle Scholar
  • 39 Anderson SW, Kruskal JB, Kane RA. Benign hepatic tumors and iatrogenic pseudotumors. Radiographics 2009; 29 (01) 211-229
    CrossrefPubMedGoogle Scholar
  • 40 Brodsky RI, Friedman AC, Maurer AH, Radecki PD, Caroline DF. Hepatic cavernous hemangioma: diagnosis with 99mTc-labeled red cells and single-photon emission CT. AJR Am J Roentgenol 1987; 148 (01) 125-129
    CrossrefPubMedGoogle Scholar
  • 41 Bajenaru N, Balaban V, Săvulescu F, Campeanu I, Patrascu T. Hepatic hemangioma -review-. J Med Life 2015; 8 (Spec Issue): 4-11
    PubMedGoogle Scholar
  • 42 Donati M, Stavrou GA, Donati A, Oldhafer KJ. The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature. J Hepatobiliary Pancreat Sci 2011; 18 (06) 797-805
    CrossrefPubMedGoogle Scholar
  • 43 Bailey J, Di Carlo S, Blackwell J, Gomez D. Same day arterial embolisation followed by hepatic resection for treatment of giant haemangioma. BMJ Case Rep 2016; 2016: bcr2015213259
    CrossrefPubMedGoogle Scholar
  • 44 Igarashi G, Mikami K, Sawada N. et al. Interventional treatment for giant hepatic hemangioma accompanied by arterio-portal shunt with ascites. Intern Med 2018; 57 (19) 2847-2851
    CrossrefPubMedGoogle Scholar
  • 45 Zhou JX, Huang JW, Wu H, Zeng Y. Successful liver resection in a giant hemangioma with intestinal obstruction after embolization. World J Gastroenterol 2013; 19 (19) 2974-2978
    CrossrefPubMedGoogle Scholar
  • 46 Akhlaghpoor S, Torkian P, Golzarian J. Transarterial bleomycin-lipiodol embolization (B/LE) for symptomatic giant hepatic hemangioma. Cardiovasc Intervent Radiol 2018; 41 (11) 1674-1682
    CrossrefPubMedGoogle Scholar
  • 47 Gao J, Ji JS, Ding XM. et al. Laparoscopic radiofrequency ablation for large subcapsular hepatic hemangiomas: technical and clinical outcomes. PLoS One 2016; 11 (02) e0149755
    CrossrefPubMedGoogle Scholar
  • 48 Gao J, Fan RF, Yang JY. et al. Radiofrequency ablation for hepatic hemangiomas: a consensus from a Chinese panel of experts. World J Gastroenterol 2017; 23 (39) 7077-7086
    CrossrefPubMedGoogle Scholar
  • 49 Zhang X, Yan L, Li B. et al. Comparison of laparoscopic radiofrequency ablation versus open resection in the treatment of symptomatic-enlarging hepatic hemangiomas: a prospective study. Surg Endosc 2016; 30 (02) 756-763
    CrossrefPubMedGoogle Scholar
  • 50 Nat L, Poantă LI. Focal nodular hyperplasia (FNH). Rom J Intern Med 2014; 52 (01) 45-49
    PubMedGoogle Scholar
  • 51 Kapp N, Curtis KM. Hormonal contraceptive use among women with liver tumors: a systematic review. Contraception 2009; 80 (04) 387-390
    CrossrefPubMedGoogle Scholar
  • 52 Vogl TJ, Own A, Hammerstingl R, Reichel P, Balzer JO. Transarterial embolization as a therapeutic option for focal nodular hyperplasia in four patients. Eur Radiol 2006; 16 (03) 670-675
    CrossrefPubMedGoogle Scholar
  • 53 Myers L, Ahn J. Focal nodular hyperplasia and hepatic adenoma: evaluation and management. Clin Liver Dis 2020; 24 (03) 389-403
    CrossrefPubMedGoogle Scholar
  • 54 Vidili G, Piscaglia F, Ainora ME. et al. Focal nodular hyperplasia: new findings at Doppler ultrasonography. Eur Rev Med Pharmacol Sci 2020; 24 (23) 12288-12295
    CrossrefPubMedGoogle Scholar
  • 55 Birn J, Williams TR, Croteau D, Schwartz S, Sturza S, Getzen T. Transarterial embolization of symptomatic focal nodular hyperplasia. J Vasc Interv Radiol 2013; 24 (11) 1647-1655
    CrossrefPubMedGoogle Scholar
  • 56 Zhang G, Wang M, Duan F. et al. Transarterial embolization with bleomycin for symptomatic hepatic focal nodular hyperplasia. Diagn Interv Radiol 2017; 23 (01) 66-70
    CrossrefPubMedGoogle Scholar
  • 57 Virgilio E, Cavallini M. Managing focal nodular hyperplasia of the liver: surgery or minimally-invasive approaches? A review of the preferable treatment options. Anticancer Res 2018; 38 (01) 33-36
    PubMedGoogle Scholar
  • 58 Faria SC, Iyer RB, Rashid A, Whitman GJ. Hepatic adenoma. AJR Am J Roentgenol 2004; 182 (06) 1520
    CrossrefPubMedGoogle Scholar
  • 59 Reddy SK, Kishnani PS, Sullivan JA. et al. Resection of hepatocellular adenoma in patients with glycogen storage disease type Ia. J Hepatol 2007; 47 (05) 658-663
    CrossrefPubMedGoogle Scholar
  • 60 Martin NM, Abu Dayyeh BK, Chung RT. Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage. World J Gastroenterol 2008; 14 (28) 4573-4575
    CrossrefPubMedGoogle Scholar
  • 61 Brancatelli G, Federle MP, Vullierme MP, Lagalla R, Midiri M, Vilgrain V. CT and MR imaging evaluation of hepatic adenoma. J Comput Assist Tomogr 2006; 30 (05) 745-750
    CrossrefPubMedGoogle Scholar
  • 62 van Rosmalen BV, de Graeff JJ, van der Poel MJ. et al; Dutch Benign Liver Tumour Group. Impact of open and minimally invasive resection of symptomatic solid benign liver tumours on symptoms and quality of life: a systematic review. HPB (Oxford) 2019; 21 (09) 1119-1130
    CrossrefPubMedGoogle Scholar
  • 63 Agrawal S, Agarwal S, Arnason T, Saini S, Belghiti J. Management of hepatocellular adenoma: recent advances. Clin Gastroenterol Hepatol 2015; 13 (07) 1221-1230
    CrossrefPubMedGoogle Scholar
  • 64 Krinsky G. Terminology of hepatocellular nodules in cirrhosis: plea for consistency. Radiology 2002; 224 (03) 638
    CrossrefPubMedGoogle Scholar
  • 65 Brancatelli G, Baron RL, Peterson MS, Marsh W. Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation. AJR Am J Roentgenol 2003; 180 (04) 1007-1014
    CrossrefPubMedGoogle Scholar
  • 66 Choi BI. Hepatocarcinogenesis in liver cirrhosis: imaging diagnosis. J Korean Med Sci 1998; 13 (02) 103-116
    CrossrefPubMedGoogle Scholar
  • 67 Krinsky GA, Lee VS, Nguyen MT. et al. Siderotic nodules at MR imaging: regenerative or dysplastic?. J Comput Assist Tomogr 2000; 24 (05) 773-776
    CrossrefPubMedGoogle Scholar
  • 68 Krinsky GA, Lee VS, Theise ND. et al. Hepatocellular carcinoma and dysplastic nodules in patients with cirrhosis: prospective diagnosis with MR imaging and explantation correlation. Radiology 2001; 219 (02) 445-454
    CrossrefPubMedGoogle Scholar
  • 69 Chernyak V, Fowler KJ, Kamaya A. et al. Liver imaging reporting and data system (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology 2018; 289 (03) 816-830
    CrossrefPubMedGoogle Scholar
  • 70 Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet 2021; 398 (10308): 1359-1376
    CrossrefPubMedGoogle Scholar
  • 71 Cartier V, Crouan A, Esvan M. et al; CHIC Group. Suspicious liver nodule in chronic liver disease: usefulness of a second biopsy. Diagn Interv Imaging 2018; 99 7-8 493-499
    CrossrefPubMedGoogle Scholar
  • 72 Seow J, McGill M, Wang W, Smith P, Goodwin M. Imaging hepatic angiomyolipomas: key features and avoiding errors. Clin Radiol 2020; 75 (02) 88-99
    CrossrefPubMedGoogle Scholar
  • 73 Ren N, Qin LX, Tang ZY, Wu ZQ, Fan J. Diagnosis and treatment of hepatic angiomyolipoma in 26 cases. World J Gastroenterol 2003; 9 (08) 1856-1858
    CrossrefPubMedGoogle Scholar
  • 74 Nonomura A, Enomoto Y, Takeda M, Takano M, Morita K, Kasai T. Angiomyolipoma of the liver: a reappraisal of morphological features and delineation of new characteristic histological features from the clinicopathological findings of 55 tumours in 47 patients. Histopathology 2012; 61 (05) 863-880
    CrossrefPubMedGoogle Scholar
  • 75 Chang Z, Zhang JM, Ying JQ, Ge YP. Characteristics and treatment strategy of hepatic angiomyolipoma: a series of 94 patients collected from four institutions. J Gastrointestin Liver Dis 2011; 20 (01) 65-69
    PubMedGoogle Scholar
  • 76 Zhou YM, Li B, Xu F. et al. Clinical features of hepatic angiomyolipoma. Hepatobiliary Pancreat Dis Int 2008; 7 (03) 284-287
    PubMedGoogle Scholar
  • 77 Wang CP, Li HY, Wang H. et al. Hepatic angiomyolipoma mimicking hepatocellular carcinoma: magnetic resonance imaging and clinical pathological characteristics in 9 cases. Medicine (Baltimore) 2014; 93 (28) e194
    CrossrefPubMedGoogle Scholar
  • 78 Guidi G, Catalano O, Rotondo A. Spontaneous rupture of a hepatic angiomyolipoma: CT findings and literature review. Eur Radiol 1997; 7 (03) 335-337
    CrossrefPubMedGoogle Scholar
  • 79 Huber C, Treutner KH, Steinau G, Schumpelick V. Ruptured hepatic angiolipoma in tuberous sclerosis complex. Langenbecks Arch Chir 1996; 381 (01) 7-9
    CrossrefPubMedGoogle Scholar
  • 80 Kim SH, Kang TW, Lim K, Joh HS, Kang J, Sinn DH. A case of ruptured hepatic angiomyolipoma in a young male. Clin Mol Hepatol 2017; 23 (02) 179-183
    CrossrefPubMedGoogle Scholar
  • 81 Aoki H, Arata T, Morihiro T. et al. Spontaneous rupture of a hepatic angiomyolipoma: report of a case. Clin J Gastroenterol 2014; 7 (05) 429-433
    CrossrefPubMedGoogle Scholar
  • 82 Ukai K, Fuji A, Nishiwaki J. et al. Giant hepatic angiomyolipoma associated with disseminated intravascular coagulation. Intern Med 1997; 36 (03) 186-190
    CrossrefPubMedGoogle Scholar
  • 83 Kelleher T, Staunton M, Malone D, Geoghan J, Aiden McCormick P. Budd Chiari syndrome associated with angiomyolipoma of the liver. J Hepatol 2004; 40 (06) 1048-1049
    CrossrefPubMedGoogle Scholar
  • 84 Tsui WM, Colombari R, Portmann BC. et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol 1999; 23 (01) 34-48
    CrossrefPubMedGoogle Scholar
  • 85 Yang CY, Ho MC, Jeng YM, Hu RH, Wu YM, Lee PH. Management of hepatic angiomyolipoma. J Gastrointest Surg 2007; 11 (04) 452-457
    CrossrefPubMedGoogle Scholar
  • 86 Yang X, Lei C, Qiu Y. et al. Selecting a suitable surgical treatment for hepatic angiomyolipoma: a retrospective analysis of 92 cases. ANZ J Surg 2018; 88 (09) E664-E669
    CrossrefPubMedGoogle Scholar