Two cases of hepatic angiomyolipoma with different ultrasonographic and radiographic findings

Abstract

Case 1: A 44 year-old woman was diagnosed with a liver tumor on health screening without hepatitis virus antigen and antibody. Combined imaging (contrast enhanced ultrasonography, superparamagnetic iron oxide-enhanced MRI, and CT angiography) findings suggested liver angiomyolipoma, which was later confirmed pathologically. Since no increase in the tumor size was observed after subsequent follow-ups, hepatic resection was not performed.
Case 2: A 40 year-old woman was diagnosed with a liver tumor. Unlike case 1, the possibility of HCC could not be eliminated based on combined imaging findings. Since the tumor was found to be progressively increasing in size within a short period, hepatic resection was performed. Angiomyolipoma was diagnosed based on pathological findings. Although angiomyolipoma was diagnosed in both the cases, imaging tests in case 1 showed typical findings with the presence of large amount of adipose cells in the tumor, whereas case 2 had fewer adipose cells, making diagnosis by combined imaging difficult. Ultrasonography with contrast agent, which visualizes the hepatic vein, was useful for diagnosis in case 2.