© Translational Gastrointestinal Cancer. All rights reserved. Transl Gastrointest Cancer 2015;4(4):320-325 www.amepc.org/tgc Introduction Hepatic angiomyolipoma (AML) is a rare benign tumor first described by Ishak in 1976 (1). Hepatic AML has been increasingly recognized of late as a result of wide-spread use of high resolution imaging techniques and many cases have been diagnosed by core needle biopsy of ambiguous liver masses (2). Owing to their significantly varied histological appearance, several histological variants of hepatic AML have been described viz. classical/mixed, leiomyomatous, lipomatous, myelolipomatous, angiomatous/angiomyomatous, epithelioid, trabecular, oncocytic, pleomorphic and inflammatory variants (2-5). Recognition of these entities is necessary to avoid misinterpretation as variants of hepatocellular carcinoma (HCC), melanoma or other primary or metastatic malignant neoplasms with prominent inflammation, particularly on core needle biopsy (2,6). The inflammatory variant is the least common variant of hepatic AML and shows a dense lymphoplasmacytic infiltrate which sometimes obscures the true nature of the AML. Less than fifteen cases have been reported in the literature so far (7-12). Most of these cases had displayed a minor focal conventional tumor component. However, the pathogenesis of the inflammatory reaction in hepatic AML remains poorly understood. Here we describe a new case of hepatic AML, inflammatory variant. Case report A 54-year-old woman presented with fatigue, vague abdominal pain and fullness, and anorexia. There was no history of fever or jaundice. On clinical examination, there was mild tenderness in the right hypochondrium and hepatomegaly (2 cm below the costal margin). No stigmata of tuberous sclerosis were seen. All the laboratory parameters were within normal limits with the exception of microcytic, hypochromic anemia (Hb: 9.8 g/dL), Case Report Hepatic angiomyolipoma, inflammatory variant: a case report and review of literature Smrita Singh, Chennagiri S. Premalata, Rekha V. Kumar, Swamivelu Krishnamurthy Kidwai Memorial Institute of Oncology, Bangalore, India Correspondence to: Chennagiri S. Premalata. Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India. Email: prema_venka@hotmail.com. Abstract: Hepatic angiomyolipoma (AML) is a rare neoplasm. Based on its wide histomorphological range, several distinctive histological variants have been described. However, hepatic AML displaying predominantly or exclusively inflammatory pattern closely mimicking inflammatory pseudotumor (IPT) is exceptionally rare with less than fifteen cases reported so far. We describe another case of hepatic inflammatory AML in a 54-year-old woman who presented with fatigue and vague abdominal pain. There was no history of fever or jaundice. On examination, there was mild tenderness in the right hypochondrium with mild hepatomegaly. Liver function tests were within normal limits. The patient was seronegative for hepatitis B and hepatitis C. A liver mass was detected on radiological examination which was resected. Histopathological examination revealed a neoplasm rich in lymphoplasmacytic cells with foci of spindle cells which on immunohistochemistry (IHC) were positive for melanocytic markers like Melan A and HMB45 confirming the diagnosis of inflammatory hepatic AML. Keywords: Angiomyolipoma (AML); hepatic; inflammatory; inflammatory pseudotumor (IPT) Submitted May 21, 2015. Accepted for publication Jul 14, 2015. doi: 10.3978/j.issn.2224-4778.2015.07.06 View this article at: http://dx.doi.org/10.3978/j.issn.2224-4778.2015.07.06