Abstract: Objective:To investigate the diagnosis and treatment of hepatic angiomyolipoma (HAML).
Methods:The clinical data of 15 patients with HAML who were admitted to the First Affiliated Hospital of Anhui Medical University from January 1990 to December 2010 were retrospectively analyzed. Tumor biomarkers such as serum alphafetoprotein, carcinoembryonic antigen, CA19-9 were detected, and surgical procedures were selected according to the clinical features and results of imaging diagnosis. Pathological examination was done postoperatively. Patients were followed up via out patient examination or phone call till June 2011.
Results:Five patients did not have clinical symptoms and all the patients did not have the history of hepatitis. The diagnostic rates of preoperative ultrasonography, computed tomography, magnetic resonance imaging and angiography were 3/15, 3/13,2/6 and 1/3. The lesions located in the left lobe in 4 patients, and lesions in the right lobe in 11 patients. All the tumors were solitary. All the patients received surgical treatment, including 13 received tumor enucleation and resection of adjacent normal hepatic tissues, 2 received left semihepatectomy because of the big size of the tumor. The results of postoperative histochemical staining showed that the expressions of HMB45, CD34 and Ki-67 were positive. All the patients were cured after operation, and 13 patients were followed up for 6 months to 9.8 years,with the median follow up time of 3.2 years. Eleven patients had complete follow up data, and 2 patients were lost to follow up at postoperative year 9.8 and 6, respectively. All patients had disease free survival, with no tumor recurrence or metastasis.
Conclusions:HAML has no specific symptoms. Preoperative imaging diagnosis of HAML is difficult. Positive expression of HMB45 is a definitive proof for histopathological diagnosis of HAML. Surgical resection is the therapy of choice for HAML. The prognosis of patients is good.