Multimodal imaging in hepatic epithelioid angiomyolipoma: a case report

Background Hepatic epithelioid angiomyolipoma (HEAML) is a rare mesenchymal neoplasm that can occasionally exhibit malignant behavior, such as postoperative recurrence or distant metastasis. Most HEAML patients are female, and it is difficult to distinguish them from other liver tumors. The diagnostic accuracy rate is less than 32%. We present a case of HEAML in an elderly woman with mild fatty liver, without a history of hepatitis, tuberculosis. The patient underwent early laparoscopic liver tumor resection. Case description A 69-year-old woman presented with intermittent right upper abdominal discomfort. Imaging revealed an ovoid liver mass. She was in good overall health, with no history of chronic diseases, hepatitis, tuberculosis, allergies, surgeries, trauma, or blood transfusions. Laboratory tests were normal, with negative results for carcinoembryonic antigen and alpha-fetoprotein (AFP). After computed tomography (CT) and magnetic resonance imaging (MRI) examinations, the patient underwent laparoscopic liver tumor resection. Conclusions HEAML, the rare tumor, with a degree of malignant potential, predominantly affects elderly women. Certain characteristics on CT and MRI facilitate its differentiation from other intrahepatic lesions. In our case, a multimodal approach was utilized, and detailed imaging analysis of the tumor may serve as a reference for its accurate diagnosis.