Hepatic perivascular epithelioid cell tumours in children with tuberous sclerosis.

Michaela Janks, Amelia Heaford, Maesha Deheragoda, Nedim Dino Hadzic

BMJ case reports 2020 Dec 09

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Perivascular epithelioid cell tumours are a novel histological description of mesenchymal tumours consisting of perivascular and epithelioid cells. Angiomyolipomas are one of the commoner types of this tumour group. They are typically associated with the inherited condition tuberous sclerosis (TS). In TS they are often seen arising in the kidneys and brain, although much more rarely can be seen in the liver. While usually thought of as benign tumours there is little evidence to predict whether they will progress to malignancy. Currently, there is no recommended best management strategy between resection and surveillance. We report two patients with TS seen in our centre with these described PEComa liver lesions histologically, however only one required a resection. On review of the literature, features such as increased size, rapid growth and vascular invasion would be concerning for possible malignant potential and therefore merit resection, as well as significant symptoms. © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Michaela Janks, Amelia Heaford, Maesha Deheragoda, Nedim Dino Hadzic. Hepatic perivascular epithelioid cell tumours in children with tuberous sclerosis. BMJ case reports. 2020 Dec 09;13(12)