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      Hepatic epithelioid angiomyolipoma is scattered and unsuitable for surgery: a case report

      case-report

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          Abstract

          Hepatic epithelioid angiomyolipoma (HEAML) is a rare tumour of mesenchymal tissue with a malignant tendency. Occurring most frequently in women, the relative incidence in men and women, according to incomplete statistics, is approximately 1:5. In rare cases, disease occurrence and development is hidden. Lesions are generally discovered as chance findings by patients; abdominal pain is the first symptom, and imaging has no specificity in diagnosing the disease. Therefore, great difficulties exist in the diagnosis and treatment of HEAML. Here, the case of a 51-year-old female patient with a history of hepatitis B, and abdominal pain over 8 months as the initial symptom, is described. The patient was found to have multiple intrahepatic angiomyolipoma. Due to the small and scattered foci, complete resection was impossible, and because of her history of hepatitis B, conservative treatment was undertaken, with the patient undergoing regular follow-up. When hepatic cell carcinoma could not be excluded, the patient was treated with transcatheter arterial chemoembolization. No tumour neogenesis or metastasis was detected at the 1-year follow-up.

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          The CARE guidelines: consensus-based clinical case reporting guideline development.

          A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. © 2013 Gagnier et al.; licensee Wiley Periodicals, Inc.
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            Hepatocellular carcinoma.

            Hepatocellular carcinoma is the sixth most prevalent cancer and the third most frequent cause of cancer-related death. Patients with cirrhosis are at highest risk of developing this malignant disease, and ultrasonography every 6 months is recommended. Surveillance with ultrasonography allows diagnosis at early stages when the tumour might be curable by resection, liver transplantation, or ablation, and 5-year survival higher than 50% can be achieved. Patients with small solitary tumours and very well preserved liver function are the best candidates for surgical resection. Liver transplantation is most beneficial for individuals who are not good candidates for resection, especially those within Milano criteria (solitary tumour ≤5 cm and up to three nodules ≤3 cm). Donor shortage greatly limits its applicability. Percutaneous ablation is the most frequently used treatment but its effectiveness is limited by tumour size and localisation. In asymptomatic patients with multifocal disease without vascular invasion or extrahepatic spread not amenable to curative treatments, chemoembolisation can provide survival benefit. Findings of randomised trials of sorafenib have shown survival benefits for individuals with advanced hepatocellular carcinoma, suggesting that molecular-targeted therapies could be effective in this chemoresistant cancer. Research is active in the area of pathogenesis and treatment of hepatocellular carcinoma. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              Ki67 targeted strategies for cancer therapy

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                Author and article information

                Journal
                J Int Med Res
                J Int Med Res
                IMR
                spimr
                The Journal of International Medical Research
                SAGE Publications (Sage UK: London, England )
                0300-0605
                1473-2300
                February 2023
                16 February 2023
                : 51
                : 2
                : 03000605231154657
                Affiliations
                [1 ]Department of Emergency Surgery, Lu'an People's Hospital of Anhui Province, Lu'an, Anhui, China
                [2 ]Department of Obstetrics and Gynaecology, Affiliated Hospital of Tongchuan City Maternal and Child Health Care, Tongchuan, Shaanxi, China
                [3 ]School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
                [4 ]Department of Pathology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
                [5 ]Graduate Student Affairs Office, Xi’an Medical University, Xi’an, Shaanxi, China
                Author notes
                [*]Siyuan Pan, Hanguang Campus of Xi’an Medical University, 74 Hanguang North Road, Xi’an, Shaanxi Province, 712000, China. Email: 296033502@ 123456qq.com
                Author information
                https://orcid.org/0000-0003-0648-1442
                Article
                10.1177_03000605231154657
                10.1177/03000605231154657
                9936533
                36794565
                308c2768-3e45-40ba-b473-6d5e31daf481
                © The Author(s) 2023

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 11 September 2022
                : 17 January 2023
                Funding
                Funded by: Natural Science Foundation of Shaanxi Province, FundRef https://doi.org/10.13039/501100007128;
                Award ID: 2020JQ-945
                Categories
                Case Reports
                Custom metadata
                ts2

                hepatic epithelioid angiomyolipoma,multiple intrahepatic angiomyolipoma,diagnosis,conservative treatment,tace,regular follow-up

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