Abstract
A 63-year-old woman was referred to our hospital because of fever and cough. Thoracic and abdomen computed tomography (CT) revealed giant tumor 16 cm in diameter. It existed under the left diaphragm, adjacent to the pancreas tail and the spleen. In contrast enhanced CT and magnetic resonance imaging (MRI), itʼs edge and inside were dyed heterogeneity. The structure like the adipose tissue and vessel and soft tissue were seen as for the inside, and feeding vessels had diverged from the left hepatic artery. Therefore, we diagnosed it as the hepatic angiomyolipoma and we performed the operation. The tumor continued from the liver, not infiltrating neighboring organs.
Pathological findings showed that mature adipose cells proliferated. Epitheloid cells and spindle-shaped cells around vessels were positive for HMB-45 staining. There were mitotic rate, 2/10 HPF. There were 10% positive cells for MIB-1 staining. Therefore, we diagnosed it was hepatic angiomyolipoma with malignant potential. Hepatic angiomyolipoma has been thought to be benign. Malignant hepatic angiomyolipoma is very rare, we report this case with a review of the literature.
