S Block1, L Theilmann. 1. Medizinische Klinik II, Städtisches Klinikum Pforzheim.
Abstract
HISTORY AND ADMISSION FINDINGS: A 66-year-old woman, known for 4 years to have a space-occupying lesion in the liver thought to be a lipoma, was admitted because the increasing size of the mass. She was hypertensive and had recurrent supraventricular tachycardia, but was otherwise asymptomatic and physical examination was unremarkable. INVESTIGATIONS: Laboratory tests were within normal limits. Abdominal ultrasound demonstrated a well-circumscribed, echodense space-occupying lesion. Magnetic resonance imaging revealed a hyperintense encapsulated tumour with contrast-medium enhancement. DIAGNOSIS AND TREATMENT: Because the imaging tests were equivocal, a segmental liver resection was performed to exclude malignancy. Histological examination revealed an angiomyolipoma of the liver. CONCLUSION: Angiolipoma is a benign mixed-cell tumour that very rarely affects the liver but must be included in the differential diagnosis of hepatic space-occupying lesions. Its manifestations may be highly variable and histological examination is required if there is any uncertainty about possible malignancy. If the biopsy is diagnostic of a benign lesion, expectant observation with regular monitoring is indicated.
HISTORY AND ADMISSION FINDINGS: A 66-year-old woman, known for 4 years to have a space-occupying lesion in the liver thought to be a lipoma, was admitted because the increasing size of the mass. She was hypertensive and had recurrent supraventricular tachycardia, but was otherwise asymptomatic and physical examination was unremarkable. INVESTIGATIONS: Laboratory tests were within normal limits. Abdominal ultrasound demonstrated a well-circumscribed, echodense space-occupying lesion. Magnetic resonance imaging revealed a hyperintense encapsulated tumour with contrast-medium enhancement. DIAGNOSIS AND TREATMENT: Because the imaging tests were equivocal, a segmental liver resection was performed to exclude malignancy. Histological examination revealed an angiomyolipoma of the liver. CONCLUSION: Angiolipoma is a benign mixed-cell tumour that very rarely affects the liver but must be included in the differential diagnosis of hepatic space-occupying lesions. Its manifestations may be highly variable and histological examination is required if there is any uncertainty about possible malignancy. If the biopsy is diagnostic of a benign lesion, expectant observation with regular monitoring is indicated.
Authors: P Kasper; B Holzapfel; R Whaba; M Suchan; U Drebber; T Goeser; G Michels; N Jaspers Journal: Internist (Berl) Date: 2020-01 Impact factor: 0.743