日本外科学会官方杂志Surgery today发表了山东大学齐鲁医院普外科李涛副主任医师关于肝脏血管平滑肌脂肪瘤的文章。该文章阐述了手术切除的25例肝脏血管平滑肌脂肪瘤临床病理特点，影像学表现，外科治疗及预后。尽管肝脏血管平滑肌脂肪瘤被考虑是良性疾病，但是少数肝脏血管平滑肌脂肪瘤表现出恶性肿瘤所特有的侵袭转移的特性，因此对于肝脏血管平滑肌脂肪瘤应当采取积极的外科手术治疗。
Hepatic angiomyolipoma: a retrospective study of 25 cases.
Source
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China.
Abstract
PURPOSE:
We report our experience of diagnosing and treating hepatic angiomyolipoma (HAML), a rare benign mesenchymal tumor.
METHODS:
We analyzed retrospectively the clinicopathologic, radiological, and operative data of 25 patients who underwent surgery for HAML at our institute between November 2001 and May 2006.
RESULTS:
Most patients (20/25) were asymptomatic and had normal liver function. Ultrasonography (US) showed a heterogeneous hyperechoic mass in 13 of 23 patients, precontrast computed tomography (CT) showed that all of 12 lesions scanned were hypodense, and magnetic resonance imaging (MRI) showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in most (5/6) lesions. Marked enhancement in the arterial phase was seen in 10 of 12 lesions on CT scans and in 6 of 6 lesions on MRI scans. All tumors were composed of varying proportions of smooth muscle, adipose tissue, and blood vessels, and showed positive immunohistochemical staining for HMB-45. All patients underwent partial hepatectomy and there was no evidence of recurrence after a median follow-up of 43 months.
CONCLUSION:
The radiological features of HAML vary according to its histological components. The definitive diagnosis of HAML is challenging and depends on the presence of HMB-45-positive myoid cells. Hepatic angiomyolipoma is treated effectively with surgery and the prognosis is good.
