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

Andrew Park; 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

doi:10.14701/ahbps.24-033

Ann Hepatobiliary Pancreat Surg

Published online June 13, 2024; https://doi.org/10.14701/ahbps.24-033

Andrew Park^1,*, Kush Savsani^1,*, Anjelica Alfonso¹, Ester Jo¹, Bryce Hatfield², Daisuke Imai³, Aamir Khan³, Amit Sharma³, Irfan Saeed³, Vinay Kumaran³, Adrian Cotterell³, David Bruno³, Yuzuru Sambommatsu³, Seung Lee³

¹Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA,
²Department of Pathology, Virginia Commonwealth University Health System, Richmond, VA, USA,
³Department of Transplant Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA

Correspondence to: Seung Lee, MD
Department of Transplant Surgery, Virginia Commonwealth University Health System, 1200 E. Broad St, Richmond, VA 23298, USA
Tel: +1-434-953-0101, Fax: +1-804-827-1016, E-mail: seung.lee@vcuhealth.org
ORCID: https://orcid.org/0000-0002-4382-7871

*These authors contributed equally to this study.

Received February 5, 2024; Revised April 30, 2024; Accepted April 30, 2024.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.; Keywords : Robotics; Angiomyolipoma; Liver neoplasms