Case Report
 
Hepatic angiomyolipoma presenting with chronic epigastric pain: A case report
Anthony Relucio Perez1, Clarence Yacapin2
1MD, MHA, Vice Chair for Training, Department of Surgery, UP College of Medicine and Philippine General Hospital, Section Chief, Hepatobiliary and Pancreatic Surgery Asian Hospital and Medical Center
2MD, Clinical Fellow Section of Minimally Invasive Surgery, Department of Surgery Asian Hospital and Medical Center

Article ID: 100070IJHPDAP2017
doi: 10.5348/ijhpd-2017-70-CR-6

Address correspondence to:
Anthony Relucio Perez
108 Dayap Street Ayala Alabang
Muntinlupa, NCR
Philippines, 1780
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How to cite this article
Perez AR, Yacapin C. Hepatic angiomyolipoma presenting with chronic epigastric pain: A case report. Int J Hepatobiliary Pancreat Dis 2017;7:28–31.


Abstract
Introduction: Angiomyolipomas primarily arising from the liver are rare. Hepatic angiomyolipoma (HAML) is a rare tumor characterized by the presence of blood vessels, muscle tissue and adipose tissue with only about 300 reported cases to date. This is the first case reported in literature of a Filipino patient.
Case Report: A 49-year-old Filipino female presented with a two-year history of recurrent epigastric pain. Abdominal magnetic resonance imaging revealed a fat-containing lesion in the left liver lobe. Serial follow-up revealed progressive enlargement on imaging studies. Serologic tests were negative for malignancy or infection. The patient underwent left hepatic lateral segmentectomy which revealed a 7.5x7 cm friable mass involving hepatic segments II and III. Histopathology showed mature fat cells with a few thick-walled blood vessels and spindled smooth muscle cells with no atypia. Homatropine methylbromide-45 test showed strong and diffused staining confirming angiomyolipoma.
Conclusion: Clinical evaluation and a comprehensive analysis of ultrasonography,computed tomography scan and magnetic resonance imaging scan are essential for correct preoperative diagnosis. Symptoms, malignant potential and inability to distinguish from liver malignancies may indicate surgical resection as the best treatment option.

Keywords: Angiomyolipoma, Hepatic mass, Liver tumors


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Author Contributions
Anthony Relucio Perez – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Clarence Yacapin – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Anthony Relucio Perez et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.