Fact-sheet: Hepatic angiomyolipoma
Updated on 09/05/2018 at 4:13 PM
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Definition
Rare benign mesenchymal tumor of the liver
Clinical features
Mean age: 50 years.
Female predominance.
Possible association with tuberous sclerosis of Bourneville.
Symptoms:
- Most often an incidental finding.
- Right upper quadrant pain.
- Hemorrhagic shock in case of lesion rupture.
Laboratory findings
Liver function tests most often normal.
Ultrasound
Intrahepatic lesion.
Variable size.
Well-defined.
Predominantly hyperechoic.
Posterior acoustic enhancement.
CT
Variable size.
Nodular appearance.
Heterogeneous appearance.
Variable density.
Mixed component with characteristic fat-density area.
Variable enhancement.
Possible intralesional pseudoaneurysmal formations.
Arterial phase enhancement without portal phase washout.
MRI
Heterogeneous.T1 hyperintensity of the fatty components, T1 hypointensity otherwise.Loss of fat signal on fat-suppressed sequences.Variable T2 signal depending on tumor composition.
Management
Simple surveillance since there is no risk of malignant transformation.
Resection if the lesion is symptomatic.
Differential diagnosis
Hepatocellular carcinoma.
Intrahepatic cholangiocarcinoma, but no fatty component.