To investigate the diagnosis, treatment and efficacy of hepatic angiomyolipoma (HAML).

Clinical data of 35 patients pathologically diagnosed with HAML undergoing surgical resection in the Fifth Medical Center of Chinese PLA General Hospital from January 2011 to January 2020 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 13 patients were male and 22 female, aged from 26 to 63 years, with a median age of 48 years. 32 patients were diagnosed with single lesion and 3 cases with multiple lesions. The maximum diameter was ranged from 1.1 to 15.3 cm, and the median diameter was 5.1 cm. The lesions were located in the left lobe of 17 cases, in the right lobe of 14 cases, and in bilateral lobes of 4 cases, respectively. The diagnosis, treatment and clinical efficacy of 35 patients were analyzed.

Preoperatively, 5 cases were diagnosed with HAML, accounting for only 14%. 13 patients were diagnosed with primary liver cancer, 4 cases of hepatic adenoma, 1 case of inflammatory pseudotumor, and 12 cases remained undiagnosed. 33 patients underwent surgical resection. Radiofrequency ablation was performed contemporarily in patients with surgical margin of >1 cm or multiple isolated nodules in small diameter. Postoperatively, all 33 patients were pathologically diagnosed with HAML. Positive HMB45 was detected by immunohistochemical staining, including 22 cases of mixed type, 5 cases of vascular type, 4 cases of myomatous type and 2 cases of lipomatous type. The other 2 patients were pathologically diagnosed by preoperative biopsy and subsequently received ultrasound-guided radiofrequency ablation. All patients recovered well. All patients obtained favorable prognosis. 1 case of myomatous type HAML recurred half a year after surgery, which was properly controlled by interventional embolization, and no significant progression was reported during 2-year follow-up. No recurrence or distant metastasis occurred in the remaining patients during postoperative followed-up for more than 2 years.

HAML is a rare benign liver lesion. However, it represents clinical manifestations of malignant tendency. Imaging examination lacks diagnostic specificity for HAML, which is likely to be misdiagnosed. For the undiagnosed cases, pathological examination can be taken as the diagnostic criteria. Surgical resection yields favorable clinical prognosis, which is highly recommended for eligible patients.