Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2021; 9(8): 1931-1939
Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1931
Epithelioid angiomyolipoma of the pancreas: A case report and review of the literature
Qing-Qing Zhu, Zhong-Feng Niu, Fei-Dan Yu, Yan Wu, Guang-Bin Wang
Qing-Qing Zhu, Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
Qing-Qing Zhu, Zhong-Feng Niu, Fei-Dan Yu, Yan Wu, Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Guang-Bin Wang, Department of Radiology, Shandong Medical Imaging Research Institue, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
Author contributions: Zhu QQ collected the clinical data of this patient and drafted the manuscript; Niu ZF reviewed the literature and drafted the manuscript; Yu FD and Wu Y performed the epithelioid angiomyolipoma consultation and reviewed the literature; Niu ZF and Wu Y were responsible for the revision of the manuscript for important intellectual content; Wu Y and Wang GB contributed equally to the manuscript polishing; all authors issued final approval for the version to be submitted.
Informed consent statement: The patient provided informed written consent for publication of this report and any accompanying images.
Conflict-of-interest statement: None declared.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guang-Bin Wang, MD, Chief Doctor, Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, No. 324 Jinwu Road, Huaiyin District, Jinan 250021, Shandong Province, China. wgb7932596@hotmail.com
Received: November 10, 2020
Peer-review started: November 10, 2020
First decision: December 13, 2020
Revised: December 25, 2020
Accepted: January 14, 2021
Article in press: January 14, 2021
Published online: March 16, 2021
Processing time: 115 Days and 9.1 Hours
Abstract
BACKGROUND

Angiomyolipomas (AMLs), belonging to the family of mesenchymal tumors, are considered benign lesions that occur mostly in the kidney or as a part of tuberous sclerosis. Epithelioid AML (EAML) is a rare type of AML that appears to have malignant potential. Extrarenal AMLs usually occur in the liver according to the retrieved literature reports. There have been only two previous reports of monofocal primary AML of the pancreas; however, no cases of primary monotypic EAML of the pancreas have been reported.

CASE SUMMARY

An asymptomatic 59-year-old woman incidentally revealed a tumor during abdominal ultrasound examination. Routine blood tests and physical examination were within normal limits. Abdominal ultrasound revealed a 1.9-cm hypoechogenic mass in the tail of the pancreas, clearly visualized by endoscopic ultrasound. However, contrast-enhanced abdominal computed tomography scans did not demonstrate the lesion. A subsequent gadolinium-enhanced magnetic resonance imaging scan showed that the lesion had some characteristic manifestations. The lesion was initially thought to be a neuroendocrine tumor (asymptomatic PanNET). After surgical resection, histopathology and immunohistochemistry confirmed the diagnosis of EAML. At the 6-mo follow-up, no recurrence, spread, or metastasis was identified on computed tomography or magnetic resonance imaging.

CONCLUSION

The preoperative diagnosis of pancreatic AML is extremely difficult. Imaging techniques are essential for providing valuable morphological features for differential diagnosis.

Keywords: Epithelioid angiomyolipoma; Pancreas; Ultrasound; Computed tomography; Magnetic resonance imaging; Case report

Core Tip: We present a rare case of pancreatic epithelioid angiomyolipoma diagnosed after an anatomopathological examination. The patient was asymptomatic. Here are several findings from multiple modalities, including multidetector computed tomography, ultrasound, endoscopic ultrasound, magnetic resonance imaging, and providing a pathologic correlation. Awareness of the characteristic features, including immunoreactivity for the human melanoma black-45 marker, may help in the diagnosis of this rare entity. This report represents, to our knowledge, the first epithelioid angiomyolipoma arising in the pancreas.