Answer of April 2007

Clinical History:

40 year old lady presented with right upper quadrant abdominal pain for more than 2 year. Physical examination revealed massive hepatomegaly.

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Diagnosis:

Hepatic angiomyolipoma.

Discussion:

Hepatic angiomyolipoma (AML) is a rare mesenchymal tumor composing of variable amount of smooth muscle, fat and blood vessels. About 5 to 10% of hepatic AML is associated with renal AML and tuberous sclerosis (Bourneville's disease). Malignant transformation of hepatic AML has been reported. The key to correct imaging diagnosis relied on the identification of all three components of the tumor, particularly the presence of intra-tumoral fat.