A Case Report of Hepatic Angiomyolipoma with Negative Premelanosome Marker Immunoprolife with Cirrhosis

Abstract

Angiomyolipoma (AML) is a relatively rare benign mesenchymal tumor that is frequently found in the kidney and, rarely, in the liver.(1) Hepatic AML is a rare, primarily benign mesenchymal tumor, composed of blood vessels, fat tissue, and smooth muscle cells (2). Ishak reported the first hepatic AML in 1976 (3) and since then, there have been about 200 cases reported in the literature (8-13)and they have been increasing with improvement in imaging modalities, including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and fine-needle aspiration biopsy (FNAB)(4) . The hepatic AML may pose a diagnostic challenge clinically, radiologically, and pathologically because of its wide variation due to the different proportions of the three cell types which make up the tumor. In particular, in a region endemic for hepatocellular carcinoma, the diagnosis of AML by imaging modality can be difficult and frequently misdiagnosed as hepatocellular carcinoma. The definitive diagnostic study remains the histological examination coupled with immunohistochemical stains. A 44 year old female , a known case of hemangioma liver presented with abdominal distension, loss of appetite and loss of weight. CECT revealed giant liver hemangioma. Enucleation of the tumour done. Histologically, tumour composed of dilated and thick walled arteries, adipose tissue and smooth muscles .Immunohistochemistry with HMB-45 done and found to be negative.Hence this case is presented for its rarity - THE MOST DIAGNOSTIC CRITERION (5) WHICH IS LACKING HMB -45