Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(4):527-534

doi:10.14701/ahbps.24-033

Robotic management of huge hepatic angiomyolipoma:A case report and literature review

Andrew PARK 1 ; Kush SAVSANI ; Anjelica ALFONSO ; Ester JO ; Bryce HATFIELD ; Daisuke IMAI ; Aamir KHAN ; Amit SHARMA ; Irfan SAEED ; Vinay KUMARAN ; Adrian COTTERELL ; David BRUNO ; Yuzuru SAMBOMMATSU ; Seung LEE

Affiliations

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Country

Republic of Korea

Language

English

Abstract

Hepatic angiomyolipoma (HAML) is a rare, benign mesenchymal liver tumor encountered in Asia, primarily in females, and can be found within the right hepatic lobe, but also in other areas of the liver. Immunohistochemically, HAMLs are characteristically positive for human melanoma black-45 antigen (HMB-45) and can histochemically vary in the composition of angiomatous, lipomatous, and myomatous tissue, together with the presence of epithelioid cells. In this case report, we discuss a previously healthy patient presenting with bloating and previously documented concern of liver lesions, found to have HAML confirmed by surgical pathology. Surgery was decided, as HAMLs greater than 10 cm are at risk of rupture. This is one of the first documented cases of HAML resected through robot-assisted bisegmentectomy and cholecystectomy, and therefore, intraoperative images have been included to assist in the planning of future robotic cases.