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- W2968081194 abstract "A 76-year-old man was admitted for elective ascending aortic aneurysm repair. Preoperative computed tomography of the thorax incidentally revealed a 8.0 × 6.3 cm complex fat-containing hepatic lesion. There were no synthetic dysfunction or surrogates of portal hypertension: albumin 4.1 g/dL, international normalized ratio 1.1, and platelet count 373 K/mm3. Chronic liver disease workup unremarkable. Alpha-fetoprotein was 0.9 ng/mL and cancer antigen 19-9 was 0.7 U/mL. Magnetic resonance imaging of the abdomen reported a 7 × 7.5 × 7.2 cm solitary heterogeneous, predominantly fatty lesion in the left hepatic lobe with involvement of the right hepatic lobe (Figure A and B). A directed biopsy revealed mature adipose tissue, dystrophic blood vessels, and smooth muscle cells (Figure C); there was no cytologic atypia or increased mitosis. Immunohistochemical staining was positive for human melanoma black-45 melanocytic marker (Figure D), confirming a diagnosis of hepatic angiomyolipoma. Nonoperative management was recommended due to bilobar involvement and proximity to the hepatic veins. Angiomyolipoma is a rare mesenchymal tumor commonly affecting the kidney. Liver involvement is rare, with approximately 300 cases reported with variable natural history. An association with tuberous sclerosis, featuring loss of heterozygosity at TSC1 (9q34) and TSC2 (16p13), is noted in 5%–15% of hepatic angiomyolipoma; however, etiology is unknown in the majority. Treatment ranges from observation to surgical resection in those with symptoms." @default.
- W2968081194 created "2019-08-22" @default.
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- W2968081194 date "2020-09-01" @default.
- W2968081194 modified "2023-10-02" @default.
- W2968081194 title "An Incidental Liver Lesion" @default.
- W2968081194 doi "https://doi.org/10.1016/j.cgh.2019.08.006" @default.
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