Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases

Abstract Background Hepatic angiomyolipoma (HAML) is a rare liver tumor, and hepatectomy is the only effective treatment. Due to the difficulty of correct diagnosis of HAML before surgery by image studies, more than 36.6% of reported HAMLs are misdiagnosed as other malignant liver tumors before surg...

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Main Authors: Yoh Asahi, Toshiya Kamiyama, Tatsuya Orimo, Shingo Shimada, Akihisa Nagatsu, Yuzuru Sakamoto, Chihiro Ishizuka, Kazuya Hamada, Hirofumi Kamachi, Emi Takakuwa, Tomoko Mitsuhashi, Akinobu Taketomi
Format: Article
Language:English
Published: Japan Surgical Society 2021-02-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-021-01125-7
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author Yoh Asahi
Toshiya Kamiyama
Tatsuya Orimo
Shingo Shimada
Akihisa Nagatsu
Yuzuru Sakamoto
Chihiro Ishizuka
Kazuya Hamada
Hirofumi Kamachi
Emi Takakuwa
Tomoko Mitsuhashi
Akinobu Taketomi
author_facet Yoh Asahi
Toshiya Kamiyama
Tatsuya Orimo
Shingo Shimada
Akihisa Nagatsu
Yuzuru Sakamoto
Chihiro Ishizuka
Kazuya Hamada
Hirofumi Kamachi
Emi Takakuwa
Tomoko Mitsuhashi
Akinobu Taketomi
author_sort Yoh Asahi
collection DOAJ
description Abstract Background Hepatic angiomyolipoma (HAML) is a rare liver tumor, and hepatectomy is the only effective treatment. Due to the difficulty of correct diagnosis of HAML before surgery by image studies, more than 36.6% of reported HAMLs are misdiagnosed as other malignant liver tumors before surgery. As there are only few reported cases in which HAMLs were removed using laparoscopic hepatectomy, the effectiveness of laparoscopic hepatectomy for such HAMLs in which are diagnosed as other malignant liver tumor before surgery has not been reported. Case presentation Case 1: a 58-year-old female with a history of treatment for autoimmune hepatitis was preoperatively diagnosed with hepatocellular carcinoma (size: 20 mm) in segment 7 (S7) of the liver. The tumor was removed by laparoscopic partial resection and was diagnosed as a HAML through a pathological examination. The patient’s postoperative course was good, and she was recurrence-free at 37 months after the hepatectomy. Case 2: a 29-year-old female with a history of surgery for a right mature cystic teratoma was referred to our department to receive treatment for a growing 20-mm liver tumor with some calcification, which arose in S3 of the liver. A metastatic liver tumor derived from the mature cystic teratoma was suspected, and laparoscopic left lateral sectionectomy was performed. The liver tumor was diagnosed as a HAML after a pathological examination. The patient’s postoperative course was unremarkable, and more than 54 months have passed since the hepatectomy without any recurrence. Conclusions Two cases in which HAMLs were preoperatively diagnosed as other malignant liver tumor were successfully removed by laparoscopic hepatectomy with a correct postoperative diagnosis. Laparoscopic hepatectomy for the present 2 cases of HAML seemed to be effective for providing a correct diagnosis after the curative removement of liver tumor with a smaller invasion compared to open hepatectomy, and for denying risk of dissemination of the malignant tumor by needle biopsy that had to be considered before ruling out malignant tumor.
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spelling doaj-art-33603b7dabf54e11a0779821550a51b72025-08-20T03:28:37ZengJapan Surgical SocietySurgical Case Reports2198-77932021-02-01711510.1186/s40792-021-01125-7Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 casesYoh Asahi0Toshiya Kamiyama1Tatsuya Orimo2Shingo Shimada3Akihisa Nagatsu4Yuzuru Sakamoto5Chihiro Ishizuka6Kazuya Hamada7Hirofumi Kamachi8Emi Takakuwa9Tomoko Mitsuhashi10Akinobu Taketomi11Department of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalDepartment of Surgical Pathology, Hokkaido University HospitalDepartment of Surgical Pathology, Hokkaido University HospitalDepartment of Gastroenterological Surgery I, Hokkaido University HospitalAbstract Background Hepatic angiomyolipoma (HAML) is a rare liver tumor, and hepatectomy is the only effective treatment. Due to the difficulty of correct diagnosis of HAML before surgery by image studies, more than 36.6% of reported HAMLs are misdiagnosed as other malignant liver tumors before surgery. As there are only few reported cases in which HAMLs were removed using laparoscopic hepatectomy, the effectiveness of laparoscopic hepatectomy for such HAMLs in which are diagnosed as other malignant liver tumor before surgery has not been reported. Case presentation Case 1: a 58-year-old female with a history of treatment for autoimmune hepatitis was preoperatively diagnosed with hepatocellular carcinoma (size: 20 mm) in segment 7 (S7) of the liver. The tumor was removed by laparoscopic partial resection and was diagnosed as a HAML through a pathological examination. The patient’s postoperative course was good, and she was recurrence-free at 37 months after the hepatectomy. Case 2: a 29-year-old female with a history of surgery for a right mature cystic teratoma was referred to our department to receive treatment for a growing 20-mm liver tumor with some calcification, which arose in S3 of the liver. A metastatic liver tumor derived from the mature cystic teratoma was suspected, and laparoscopic left lateral sectionectomy was performed. The liver tumor was diagnosed as a HAML after a pathological examination. The patient’s postoperative course was unremarkable, and more than 54 months have passed since the hepatectomy without any recurrence. Conclusions Two cases in which HAMLs were preoperatively diagnosed as other malignant liver tumor were successfully removed by laparoscopic hepatectomy with a correct postoperative diagnosis. Laparoscopic hepatectomy for the present 2 cases of HAML seemed to be effective for providing a correct diagnosis after the curative removement of liver tumor with a smaller invasion compared to open hepatectomy, and for denying risk of dissemination of the malignant tumor by needle biopsy that had to be considered before ruling out malignant tumor.https://doi.org/10.1186/s40792-021-01125-7Laparoscopic hepatectomyHepatic angiomyolipoma
spellingShingle Yoh Asahi
Toshiya Kamiyama
Tatsuya Orimo
Shingo Shimada
Akihisa Nagatsu
Yuzuru Sakamoto
Chihiro Ishizuka
Kazuya Hamada
Hirofumi Kamachi
Emi Takakuwa
Tomoko Mitsuhashi
Akinobu Taketomi
Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases
Surgical Case Reports
Laparoscopic hepatectomy
Hepatic angiomyolipoma
title Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases
title_full Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases
title_fullStr Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases
title_full_unstemmed Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases
title_short Laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy: a report of 2 cases
title_sort laparoscopic hepatectomy for hepatic angiomyolipoma with preoperative diagnosis of other malignancy a report of 2 cases
topic Laparoscopic hepatectomy
Hepatic angiomyolipoma
url https://doi.org/10.1186/s40792-021-01125-7
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