Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3755
Peer-review started: October 3, 2014
First decision: October 29, 2014
Revised: November 17, 2014
Accepted: January 16, 2015
Article in press: January 16, 2015
Published online: March 28, 2015
Hepatic angiomyolipomas (AMLs) are typically benign tumors containing varying amounts of smooth muscle cells, adipose tissue, and vessels, and are commonly found in the kidney and occasionally in the liver. The preoperative diagnosis of hepatic AML is primarily made from imaging and fine-needle aspiration biopsy results, though limited experience for such diagnoses can result in misdiagnosis. Some uncommon features of hepatic AML have been reported in the literature without an objective or qualitative consensus. As the majority of cases are benign, conservative treatment of AMLs is recommended. However, in rare cases, liver transplantation has been implemented. Only five cases of malignant hepatic AML have been reported. We report a rare case of recurrent posthepatectomy malignant hepatic AML that was misdiagnosed as liver cancer in a 37-year-old woman, which was treated by liver transplantation. The imaging and pathologic findings are presented in order to provide a more concise description to aid in future diagnoses.
Core tip: Hepatic angiomyolipomas (AMLs) are typically benign tumors, with rare reports of malignant cases. Because there is a lack of experience for preoperative diagnosis, hepatic AMLs can easily be misdiagnosed. This case report not only presents some characteristics of hepatic AML and diagnostic indicators of malignancy, but also describes the successful treatment with liver transplantation.