Retroperitoneal hamartoma mimicking angiomyolipoma: a case report and review of literature

Bulletin of the National Research Centre - Tập 46 - Trang 1-5 - 2022
Lesheng Huang1, Tianzhu Liu1, Se Peng2, Hui Peng3, Jun Chen1, Jinghua Jiang1, Wanchun Zhang1, Huijia Tang1, Hongyi Li1
1Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
2Clinical Laboratory, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
3Pathology Department, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China

Tóm tắt

Hamartoma refers to the excessive focal growth of cells and tissues in organs, which is between malformation and benign tumor. Hamartomas are commonly seen in the lung, but rare in the retroperitoneum. Angiomyolipoma was also called hamartoma in the early years. Hamartoma was not separated from the concept of angiomyolipoma until perivascular epithelioid cells were found in angiomyolipoma. We reported a case of retroperitoneal hamartoma, which was suspected to be angiomyolipoma in the initial imaging findings and pathological frozen section, but the paraffin section was finally diagnosed as hamartoma. Due to the fusion of the tumor with the right psoas major muscle, it may need to be cut off for complete resection of tumor, which may damage the sacrococcygeal nerve and affect the postoperative activity function, so the tumor was just partially removed. After 6 and 22 months of follow-up, the patient was in good condition. CT re-examinations showed that the epibiotic right retroperitoneal mass size was 40 × 42 × 72 mm3 (6 months, length × width × height) and 40 × 45 × 81 mm3 (22 months, length × width × height). We describe this case and review the literature. In conclusion, retroperitoneal hamartoma is rare and difficult to differentiate from angiomyolipoma, in which perivascular epithelial cells could be found on pathological paraffin sections.

Tài liệu tham khảo

Gupta S, Kumar A, Khanna S (1980) Retroperitoneal angiomatous hamartoma. Ann Chir Gynaecol 69(4):154 Hamilton S, Mclnerney D (1981) Retroperitoneal angiomatous lymphoid hamartoma demonstrated by ultrasound. Br J Radiol 54(645):813–815 Javery OM, Lee EY (2010) Retroperitoneal hamartoma in a pediatric patient. Pediatr Radiol 40(Suppl 1):S15 Kodzo-Grey VA (2016) A review of the literature on extrarenal retroperitoneal angiomyolipoma. Int J Surg Oncol 2016:1–19 Kumar A, Fausto N (2004) Robbins and Cotran pathologic basis of disease, 7th edn. Saunders, p 498 Lange E, Black WC, Mills SE (1988) Radiologic features of retroperitoneal cystic hamartoma. Gastrointest Radiol 13(1):266–270 Lemaitre L, Robert Y, Dubrulle F, Claudon M, Duhamel A, Danjou P et al (1995) Renal angiomyolipoma: growth followed up with CT and/or US. Radiology 197(3):598–602 Li DM, Hong S (1997) TEP1, encoded by a candidate tumor suppressor locus, is a novel protein tyrosine phosphatase regulated by transforming growth factor. Can Res 57(11):2124–2129 Li J, Yen C, Liaw D, Podsypanina K, Bose S, Wang SI et al (1997) PTEN, a putative protein tyrosine phosphatase gene mutated in human brain, breast, and prostate cancer. Science 275(5308):1943–1947 Lienert AR, Nicol D (2012) Renal angiomyolipoma. BJU Int 110(Suppl 4):25–27 Mallory A, Spink WW (1968) Angiomatous lymphoid hamartoma in the retroperitoneum presenting with neurologic signs in the legs. Ann Intern Med 69(2):305–308 MMKAB C, DJGAB C, JNEAB C, PMHAB C, PELAB C, WESAB C et al (1999) Chromosomal analysis of renal angiomyolipoma by comparative genomic hybridization: evidence for clonal origin. Hum Pathol 30(3):295–299 Safak O, Mutlu U, Zafer O, Hakan O, Erkan S, Ragip O et al (2018) Giant extrarenal retroperitoneal angiomyolipoma: a rare case with a largest size. Clin Genitourin Cancer 16:e1025–e1027 Sigdel GS, Karki K, Koirala U, Joshi BD, Dhital SP (2012) Retroperitoneal hamartoma: a rare entity. JNMA 52(186):79–81 Takahashi N, Kitahara R, Hishimoto Y, Ohguro A, Hashimoto Y, Suzuki T (2003) Malignant transformation of renal angiomyolipoma: malignant transformation of renal angiomyolipoma. Int J Urol 10:271–273 Tan WH, Baris HN, Burrows PE, Robson CD, Alomari AI, Mulliken JB et al (2007) The spectrum of vascular anomalies in patients with PTEN mutations: implications for diagnosis and management. J Med Genet 44(9):594–602 Tseng CA, Pan YS, Su YC, Wu DC, Jan CM, Wang WM (2004) Extrarenal retroperitoneal angiomyolipoma: case report and review of the literature. Abdom Imaging 29(6):721–723 Wang LJ, Wong YC, Chen CJ, See LC (2002) Computerized tomography characteristics that differentiate angiomyolipomas from liposarcomas in the perinephric space. J Urol 167(2 Pt 1):490–493