A Resected Case of Hepatic Angiomyolipoma Associated with Primary Biliary Cirrhosis, Mimicking a Well-Differentiated Hepatocellular Carcinoma

Osamu Okochi, Shin Takeda*, Ryoji Hashimoto, Yuko Takami, Masashi Hattori, Hidenobu Matsushita, Daisuke Kobayashi, Kenji Tsuboi, Nobuyuki Kato and Yoshihisa Kawase

Department of Surgery, Tosei General Hospital
Department of Surgery II, Graduate School of Medicine, Nagoya University*

A 61-year-old woman treated for primary biliary cirrhosis, Sjögren's syndrome, and membranous nephropathy since age 53 and reporting right upper quadrant pain was found in abdominal computed tomography to have a 9-cm-diameter tumor occupying the left lateral hepatic segment. She reported pruritus without jaundice. Laboratory data showed elevated biliary enzyme, IgM, and antimitochondrial antibody while serum tumor and hepatitis viral markers were negative. Imaging showed a distinct boundary tumor with a capsule structure containing a rich fat component. The tumor was enhanced in the early phase by contrast medium but it was difficult to determine whether large well-differentiated hepatocellular carcinoma or hepatic angiomyolipoma was involved, necessitating left lobe hepatectomy. The definitive diagnosis on histopathological examination was angiomyolipoma. She has been well for 1 year without recurrence. We report a case of hepatic angiomyolipoma with rapid growth in the follow up of primary biliary cirrhosis.

Key words
angiomyolipoma, liver tumor, primary biliary cirrhosis

Reprint requests
Osamu Okochi Department of Surgery, Tosei General Hospital
160 Nishioiwake-cho, Seto, 489-8642 JAPAN

Accepted
July 23, 2008

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