A Case of Hepatic Angiomyolipoma which Was Preoperatively Diagnosed and Underwent Laparoscopic Hepatectomy

Shinsho Morita, Takashi Ishibashi, Hitoshi Hara, Junji Okuda, Takehiko Dohi, Kanji Nishiguchi, Mitsuhiko Iwamoto, Hitoshi Inoue and Nobuhiko Tanigawa

Department of Gastroenterological Surgery, Osaka Medical College

We present a patient who was diagnosed preoperatively with hepatic angiomyolipoma (HAML) and underwent a laparoscopic partial hepatectomy. HAML is a rare diseases in which preoperative diagnosis is frequently difficult. A 35-year-old man was found to have a mass in the left hepatic lobe. By ultrasonography, a hyperechoic shadow containing a heterogeneous portion was observed. CT scan showed a low-density mass including fat density. On T1-weighted MR images, a ring-like high signal intensity area was noted in phase, while the signal intensity decreased out of phase. Therefore, a tumor with fat component was suspected. Possible tumor makers in the blood were within normal range. Based on these findings, HAML was suspected and surgery was performed. Because the region where the tumor was located was the lateral segment of the liver (S2) near the hepatic surface, laparoscopic surgery was indicated. Laparoscopy was performed by the lifting method, and an ultrasonic dissector and microwave were primarily used for the hepatectomy. The operating time was 3 hours 10 minutes, and the blood loss was 10 ml. The pathological diagnosis confirmed HAML. Laparoscopic hepatectomy is an excellent surgical technique when it is indicated.

Key words
hepatic angiomyolipoma, laparoscopic hepatectomy

Reprint requests
Shinsho Morita Department of Gastroenterological Surgery, Osaka Medical College 2-7 Daigaku-cho, Takatsuki, 569-8686 JAPAN

Accepted
March 22, 2000

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