Article Text

Download PDFPDF
Hepatic angiomyolipoma with trace amounts of fat: a case report and literature review
  1. S-N Wang1,
  2. K-B Tsai2,
  3. K-T Lee1
  1. 1Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  2. 2Department of Pathology, Kaohsiung Medical University Hospital
  1. Correspondence to:
    K-T Lee
    Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No 100, Tzyou 1st Road, Kaohsiung 807, Taiwan; ktlee{at}


Hepatic angiomyolipoma (AML), a rare benign mesenchymal tumour, is characterised by the presence of mature adipose tissue, smooth-muscle cells and thick-walled blood vessels. Increasing attention to hepatic AMLs has led to the discovery that sufficient proportions of fat often allow for definite diagnoses preoperatively. However, the proportion of fatty tissue in these tumours is highly variable. One case of hepatic AML is reported, where the amount of fat was <1%. In this case, the viral hepatitis markers, including hepatitis B antigen and anti-hepatitis C virus antibody, were negative. The serum α-fetoprotein level was 3.4 ng/ml and in the normal range. Abdominal ultrasonography showed a hypoechoic mass measuring 5 cm in diameter and without an obvious capsule in the left lobe of the liver. A dynamic computed tomography scan showed a well-defined and slightly enhanced mass in the medial segment of the left lobe of the liver. Angiography showed that the mass was hypervascular in character. As hepatocellular carcinoma was highly suspected from these preoperative image studies, a left lobectomy was carried out. Microscopically, the amount of fat was too low to establish a diagnosis of hepatic AML. However, positive homatropine methylbromide 45 immunoreactivity of the smooth-muscle cells seemed to assist in arriving at the diagnosis.

  • AML, angiomyolipoma
  • HMB45, homatropine methylbromide 45
  • PEC, perivascular epithelioid cell
  • SMA, smooth-muscle actin
  • SMC, smooth-muscle cell

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None declared.