ABSTRACT
Introducción: El artículo reflexiona sobre la naturaleza multidimensional y compleja de la ética y su relación con las ciencias médicas. Objetivo: Reflexionar sobre la atención a pacientes en estadio terminal desde el punto de vista de la ética médica para una atención médica integral en el primer nivel de atención. Métodos: estudio cualitativo; se emplearon análisis documental, sistematización, análisis y síntesis de publicaciones sobre la temática estudiada como métodos teóricos, para ello se valoran los criterios de autores y resultados que se expresan en artículos publicados. Se realizaron búsquedas, tanto en bases de datos estudiadas como en las plataformas de productos del Nacional Council for Biotechnology Information de la Nacional Library of Medicine of United States of America; y de Elsevier, esta última productora de Embase y Scopus, a través del motor de búsqueda Google Académico, en español e inglés, y sin límite de tiempo. Se emplearon los términos: ética médica, deontología médica, relación médico-paciente, paciente terminal y cuidados paliativos. Se excluyeron aquellos artículos que no habían sido revisados por pares o no mostraban el texto completo. Se revisó la información suministrada por cada fuente y se sintetizó. Conclusiones: En Cuba, la bioética avanza en la medida que lo permite la estrategia de Atención Primaria de Salud, con un Programa del Médico y Enfermera de la Familia resiliente y de valores humanos demostrados nacional e internacionalmente. Como reto se plantea estimular el debate entre saberes para generar cambios a favor de los pacientes, las familias, las comunidades y la sociedad(AU)
Introduction: The article reflects on the multidimensional and complex nature of ethics and its relationship to the medical sciences. Objective: To reflect on the care of terminally ill patients from the point of view of medical ethics for comprehensive medical care at the primary level of care. Methods: A qualitative study was carried out using documentary analysis, systematization, analysis and synthesis of publications on the subject studied as theoretical methods. For this purpose, the criteria of authors and results expressed in published articles were evaluated. Searches were carried out in Spanish and English through Google Scholar, and without time limit, both in the databases studied and in the product platforms of the National Council for Biotechnology Information of the National Library of Medicine of the United States of America and Elsevier. The terms: medical ethics, medical deontolog, physician-patient relationship, terminal patient and palliative care were used. Articles that were not peer-reviewed and those that did not show the full text were excluded. The information provided by each source was reviewed and synthesized. Conclusions: In Cuba, bioethics advances to the extent allowed by the Primary Health Care strategy, with a resilient Family Physician and Nurse Practitioner Program and human values demonstrated nationally and internationally. The challenge is to stimulate the debate between knowledge to generate changes in favor of patients, families, communities and society(AU)
Subject(s)
Humans , Male , Female , Palliative Care/methods , Physician-Patient Relations/ethics , Terminal Care/methods , Community Health Services , Ethics, MedicalABSTRACT
Históricamente dentro de la enseñanza médica y en la constitución de las estructuras organizacionales y la cultura médica se ha puesto poco énfasis en la promoción y la enseñanza de habilidades interpersonales, esenciales para que el personal clínico ofrezca un trato humanizado a sus pacientes y a sus equipos de trabajo. Así mismo, han sido muy pocos los esfuerzos por entender las consecuencias que tienen las presiones típicas de la formación médica en las condiciones de vida y salud mental de los estudiantes. Por esto, la presente revisión narrativa de la literatura tiene como objetivo identificar los tipos de currículos existentes y establecer sus implicaciones, en particular los currículos ocultos, en la aparición de factores de riesgo para la salud mental en estudiantes de Medicina. Esta reflexión sirve de referencia cuando se están planteando en Latinoamérica reformas curriculares que buscan transformar la enseñanza de la Medicina y dar un giro a la profesión médica
Historically, within medical education and in the constitution of organizational structures and medical culture, little emphasis has been placed on the promotion and teaching of inter-personal skills, which is essential to offer a humanised treatment of clinical staff with their patients and their co-workers. Likewise, there have been very few efforts to understand the consequences of the typical pressures of medical training on the living conditions and mental health of students. Therefore, the present narrative review of the literature aims to identify the existing types of curricula and establish their implications, in particular the hidden curricula, and in the appearance of risk factors for mental health in medical students. This reflection serves as a reference when curriculum reforms are being considered in Latin America that aim to transform the teaching of medicine and transform the medical profesión
Subject(s)
Humans , Health Promotion/organization & administration , Mental Health , Students, Medical/psychology , Curriculum/standards , Professional Role/history , Competency-Based Education/standards , Students, Medical/statistics & numerical data , Socialization , Education/history , Education/standards , Physician's Role/historyABSTRACT
Introducción: En comparación con otras áreas quirúrgicas, la resección hepática laparoscópica (RHL) no se ha aplicado de forma generalizada y en la actualidad menos del 20% de las hepatectomías se realiza por vía laparoscópica en todo el mundo. El objetivo de nuestro estudio fue evaluar la aplicabilidad y la proporción de RHL en nuestro departamento. Métodos Los datos de morbimortalidad y supervivencia se extrajeron de una base de datos prospectiva con 749 resecciones hepáticas realizadas durante un período de 10 años en un solo centro. Resultados: Entre 2005 y 2015 se realizaron 150 RHL. En el 87% de los pacientes la indicación fue la presencia de tumores hepáticos primarios o metastásicos. Se realizaron 30 hepatectomías mayores (20%) y el 80% fueron resecciones menores, realizadas en todos los segmentos del hígado. Doce pacientes fueron operados 2veces y 2 pacientes tuvieron una tercera RHL. La proporción de RHL aumentó del 12% en 2011 al 62% en el último año. La tasa de conversión fue del 9%. En general, la tasa de morbilidad fue del 36%, pero solo 1/3 se clasificaron como graves. La tasa de mortalidad a los 90 días fue del 1%. La mediana de estancia fue de 4 días y la tasa de reingresos fue del 6%. Conclusiones: La aplicación de RHL ha sido rápida y progresiva, con resultados de morbimortalidad comparables a las de las series publicadas en la literatura. En los últimos 2 años más de la mitad de las hepatectomías se realiza por vía laparoscópica en nuestro centro (AU)
Introduction: Compared to other surgical areas, laparoscopic liver resection (LLR) has not been widely implemented and currently less than 20% of hepatectomies are performed laparoscopically worldwide. The aim of our study was to evaluate the feasibility, and the ratio of implementation of LLR in our department. Methods: We analyzed a prospectively maintained database of 749 liver resections performed during the last 10-year period in a single centre. Results: A total of 150 (20%) consecutive pure LLR were performed between 2005 and 2015. In 87% of patients the indication was the presence ofprimary or metastatic liver malignancy. We performed 30 major hepatectomies (20%) and (80%) were minor resections, performed in all liver segments. Twelve patients were operated twice and 2 patients underwent a third LLR. The proportion of LLR increased from 12% in 2011 to 62% in the last year. Conversion rate was 9%. Overall morbidity rate was 36% but only one third were classified as severe. The 90-day mortality rate was 1%. Median hospital stay was 4 days and the rate of readmissions was 6%. Conclusions: The implementation of LLR has been fast with morbidity and mortality comparable to other published series. In the last 2 years more than half of the hepatectomies are performed laparoscopically in our centre (AU)
Subject(s)
Humans , Hepatectomy/statistics & numerical data , Liver Neoplasms/surgery , Laparoscopy/statistics & numerical data , Cholangiocarcinoma/surgery , Indicators of Morbidity and Mortality , Treatment Outcome , Postoperative ComplicationsABSTRACT
INTRODUCTION: Among several regions in the world hepatic hydatidosis can be considered endemic. Currently there are many available treatments for this disease, been surgery the most effective one. Surgical procedures can be divided in two main groups, radical and non-radical procedures. The goal of this work is to evaluate the morbidity, mortality and percentage of recurrence in patients treated with hepatectomies, comparing them with other publications. MATERIAL AND METHODS: This retrospective study was carried out in a series from Spain and Argentina. We analyzed the following data: sex, age, type of resection, associated surgical gestures, presence of liver disease, operative time, blood transfusion, morbidity, mortality, hospital stay, re-hospitalization, recurrence and follow up. Dindo--Clavien classification was used for complications, and International Hepato-Pancreato-Biliary Association (IHPBA) Brisbane classification for hepatectomies. Mortality was considered until 90 days after surgery. To evaluate the recurence we only included patients followed over 6 months. RESULTS: Indications for liver resections were performed in patients with cysts larger than 5 centimeters, multiple cysts, large cysts, with bile duct communicated or suspicion of this communication. Five patients required blood transfusions (10
) with a median for these 5 patients of 740 ml and 74 ml for the complete series. The median operative time was 186 minutes (range 45 to 1,050 minutes). Median hospital stay was 7.7 days. Monitoring more than 6 months was conducted in 38 patients. CONCLUSIONS: We believe that hepatic hydatid disease is a multifaceted disease and requires more than one therapeutic approach. Hepatectomy with complete resection of the parasite offers the possibility of doing so in a controlled and safe way by experienced hands, ensuring good results in the treatment of this disease.
Subject(s)
Echinococcosis, Hepatic/mortality , Echinococcosis, Hepatic/surgery , Hepatectomy , Adult , Aged , Argentina , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recurrence , Retrospective Studies , Spain , Treatment OutcomeABSTRACT
INTRODUCTION: Among several regions in the world hepatic hydatidosis can be considered endemic. Currently there are many available treatments for this disease, been surgery the most effective one. Surgical procedures can be divided in two main groups, radical and non-radical procedures. The goal of this work is to evaluate the morbidity, mortality and percentage of recurrence in patients treated with hepatectomies, comparing them with other publications. MATERIAL AND METHODS: This retrospective study was carried out in a series from Spain and Argentina. We analyzed the following data: sex, age, type of resection, associated surgical gestures, presence of liver disease, operative time, blood transfusion, morbidity, mortality, hospital stay, re-hospitalization, recurrence and follow up. Dindo--Clavien classification was used for complications, and International Hepato-Pancreato-Biliary Association (IHPBA) Brisbane classification for hepatectomies. Mortality was considered until 90 days after surgery. To evaluate the recurence we only included patients followed over 6 months. RESULTS: Indications for liver resections were performed in patients with cysts larger than 5 centimeters, multiple cysts, large cysts, with bile duct communicated or suspicion of this communication. Five patients required blood transfusions (10
) with a median for these 5 patients of 740 ml and 74 ml for the complete series. The median operative time was 186 minutes (range 45 to 1,050 minutes). Median hospital stay was 7.7 days. Monitoring more than 6 months was conducted in 38 patients. CONCLUSIONS: We believe that hepatic hydatid disease is a multifaceted disease and requires more than one therapeutic approach. Hepatectomy with complete resection of the parasite offers the possibility of doing so in a controlled and safe way by experienced hands, ensuring good results in the treatment of this disease.
Subject(s)
Echinococcosis, Hepatic/surgery , Echinococcosis, Hepatic/mortality , Hepatectomy , Adult , Argentina , Spain , Retrospective Studies , Female , Humans , Aged , Male , Middle Aged , Recurrence , Treatment Outcome , Follow-Up StudiesABSTRACT
Introducción La estenosis significativa del tronco celiaco habitualmente cursa de forma asintomática. No obstante, cuando se interrumpe la arcada de las arterias pancreatoduodenales, puede producirse isquemia visceral. El objetivo de este estudio es determinar si la estenosis preoperatoria del tronco celiaco es un factor de riesgo de complicaciones en pacientes sometidos a duodenopancreatectomía (DPC). Material y métodos Hemos analizado retrospectivamente a 58 pacientes consecutivos sometidos a DPC. Hemos relacionado la estenosis significativa del tronco celiaco con la evolución posquirúrgica. En todos los casos se ha realizado un estudio mediante tomografía computarizada multidetector (TCDM) de 16 canales en tres fases hepáticas. Hemos revisado la TCDM prequirúrgica centrándonos en la morfología del tronco celiaco, especialmente la presencia o ausencia de estenosis significativa (> 50%).Resultados Encontramos estenosis del tronco celiaco > 50% en 13 pacientes (22%). La mortalidad total fue de 3 pacientes (5%). La morbilidad total fue del 62%. En 16 pacientes (28%) hubo complicaciones graves, de los que 8 (62%) pertenecen al grupo de estenosis significativa del tronco celiaco (p=0,004); 10 pacientes (17%) presentaron fístula pancreática, 5 (38%) vs. 5 (11%) (p=0,036); 14 pacientes (24%) necesitaron reoperación, 7 (54%) vs. 7 (16%) (p=0,009); 7 pacientes (12%) presentaron hemoperitoneo, 4 (31%) vs. 3 (7%) (p=0,038), en los grupos con y sin estenosis del tronco celiaco respectivamente. Conclusiones La estenosis radiológicamente significativa del tronco celiaco es un factor de riesgo de complicaciones graves tras DPC. El estudio del calibre de la AMS con TCDM debería ser sistemático antes de una DPC. Debería valorarse preoperatoriamente la corrección de la estenosis significativa del tronco celiaco (AU)
Introduction Significant celiac trunk or artery stenosis (CAS) is normally asymptomatic. However, when the arteries of the pancreatoduodenal arcade are occluded, it could trigger avisceral ischaemia. The objective of this study is to determine whether preoperative CAS is a risk factor for developing complications in patients subjected to duodenopancreatectomy(DPC). Material and methods: We have retrospectively analysed 58 consecutive patients subjected to DPC. We have associated significant CAS with post-surgical outcome. In all cases a 16-channel multidetector computed tomography (MDCT) in three hepatic phases was performed. We have reviewed the pre-surgical MDCT focusing on the morphology of the celiacartery (CA), particularly in the presence or absence of significant stenosis (>50%). Results: We found CAS >50% in 13 patients (22%). The overall mortality was 5% (3 patients). Serious complications developed in 16 (28%) patients, 8 (62%) of whom belonged to the group with significant CAS (P = .004). Ten patients (17%) had a pancreatic fistula, 5 (38%) vs. 5 (11%)(P = .036); Fourteen patients (24%) needed new surgery, 7 (54%) vs. 7 (16%) (P = .009); Seven patients (12%) had a haemoperitoneum, 4 (31%) vs. 3 (7%) (P = .038), in the group with and without CAS, respectively. Conclusions: Significant radiological CAS is a risk factor of serious complications after DPC. The study of the calibre of the superior mesenteric artery (SMA) with MDCT should beroutine before a DPC. The correction of a significant CAS should be evaluated preoperatively (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Arterial Occlusive Diseases/complications , Celiac Artery , Pancreaticoduodenectomy/methods , Postoperative Complications/epidemiology , Retrospective Studies , Risk FactorsABSTRACT
Introducción En el tumor de Klatskin la única posibilidad de cura es la extirpación quirúrgica radical. No obstante, la resección quirúrgica es difícil. Objetivo El objetivo de este trabajo es valorar la necesidad de drenaje biliar preoperatorio, el índice de resecabilidad, el porcentaje de hepatectomías, la morbimortalidad y la supervivencia a largo plazo. Material y métodos Desde el año 2005 hasta el año 2008, se estudió a 26 pacientes con tumor de Klatskin mediante tomografía computarizada helicoidal con multidetectores y colangiorresonancia magnética en casos especiales. Siete pacientes se consideraron irresecables (27%). A los restantes 19 pacientes se les realizaron 8 hepatectomías izquierdas, 5 derechas y 6 resecciones exclusivamente de la vía biliar con linfadenectomía y hepático yeyunostomía a todos ellos. La resecabilidad fue del 73%, la transfusión del 53% y el drenaje biliar preoperatorio se utilizó en 7 casos (37%). La morbilidad fue del 58% y la mortalidad del 10%. La supervivencia y la recidiva a los 48 meses fueron respectivamente del 63 y del 37%.Al comparar la evolución de los 9 pacientes con bilirrubina inferior a 15mg/dl y los 10 pacientes con bilirrubina superior a 15mg/dl, no hubo diferencias en los datos epidemiológicos. Seis pacientes (67%) con bilirrubina baja frente a un paciente (10%) del grupo de bilirrubina alta habían recibido un drenaje biliar preoperatorio (p=0,02). La bilirrubina del grupo no ictérico era de 4,7±4,3 frente a 22,1±3,9 del grupo con ictericia (p<0,001). No hubo diferencias en la evolución postoperatoria. En conclusión, la resecabilidad y la supervivencia postoperatoria de los pacientes con tumor de Klatskin han mejorado sensiblemente en los últimos años. En casos seleccionados, las hepatectomías mayores en pacientes con ictericia sin desnutrición ni colangitis preoperatoria son seguras (AU)
Background Surgical resection is the only possibility of long term survival in patients with Klatskin tumours. However, surgical resection is a challenging problem and hepatic resection is often necessary. Objective The aim of our study was to assess the need for biliary drainage, resection rate and outcome of hilar cholangiocarcinoma in a single tertiary referral centre. Patients and methods From 2005 to 2008, 26 patients with Klatskin tumours were identified and assessed prospectively with multidetector CT and MR cholangiography in special cases. Seven patients (27%) were deemed to be unresectable in pre-operative staging. A total of 19 surgical procedures were performed, 8 left hepatectomies, 5 right hepatectomies and 6 resections exclusively of the biliary tree. Resection rate was 73%, transfusion rate 53% and preoperative biliary drainage was performed only in 7 cases (37%). Major complications occurred in 11 (58%), including two post-operative deaths (10%).There were no differences in the epidemiological data, when we separately analysed the outcomes of the 9 patients with bilirubin <15mg/dL and the 10 patients with bilirubin >15mg/dL. Biliary drainage was required in 6 (67%) patients in the group with low bilirubin levels vs. 1(10%) in the other group (P=0.02). The mean bilirubin level in the jaundiced group was 22.1±3.9 vs. 4.7±4.3 (P<0.001) in the other group. There were no differences in the postoperative outcome between both groups. Conclusion Resection and survival rates have increased recently but still carries the risk of significant morbidity and mortality. Major hepatectomies in selected patients without percutaneous biliary drainage are safe (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Bile Duct Neoplasms/surgery , Bile Ducts, Intrahepatic , Cholangiocarcinoma/surgery , Hepatectomy , Hepatic Duct, Common , Klatskin Tumor/surgery , Bile Duct Neoplasms/complications , Cholangiocarcinoma/complications , Drainage , Hepatectomy/methods , Jaundice/etiology , Klatskin Tumor/complications , Preoperative Care , Prospective StudiesABSTRACT
La epidemia de SIDA continúa creciendo mundialmente y el conocimiento de las manifestaciones oftalmológicas permitirá mayor posibilidad de preservar la función visual en los pacientes. Se realizó una revisión bibliográfica con el propósito de describir las alteraciones oftalmológicas más frecuentes en pacientes con síndrome de inmunodeficiencia adquirida. Las manifestaciones oftalmológicas más frecuentes en los pacientes portadores de VIH/SIDA, no son característicos de procesos infecciosos, sino que responden fundamentalmente a alteraciones microvasculares retinianas no infecciosas que incluyen exudados algodonosos, presentes en más de la mitad de los casos. La retinitis por Citomegalovirus es la infección oportunista que más se presenta en estos pacientes, comportándose en algunos casos como la primera manifestación de la enfermedad. En el segmento posterior a nivel de las arcadas vasculares son comunes por citomegalovirus, las hemorragias y la necrosis, así como las granulaciones. En el segmento anterior es común la infección por Molluscum contagiosum en párpado y córnea. La neoplasia más común es el Sarcoma de Kaposi, que se presenta más comúnmente como lesiones vasculares en el fondo del saco inferior. Entre las afecciones neuroftalmlógicas más frecuentes en los pacientes con VIH/SIDA, está el papiledema, asociado a la meningitis criptocócica, como causa fundamental y a toxoplasmosis cerebral(AU)
The AIDS epidemic continues to grow worldwide and knowledge of ophthalmological manifestations allows greater potential for preservation of visual function in patients. A literature review in order to describe the most common eye disorders in patients with acquired immunodeficiency syndrome was made. The most common ophthalmological manifestations in patients with HIV/AIDS, are not characteristic of infectious processes, but respond primarily to noninfectious retinal microvascular alterations including cottony exudates present in over half the cases. Cytomegalovirus retinitis is the most opportunistic infection that occurs in these patients, in some cases acting as the first manifestation of the disease. In the posterior segment at the level of vascular arcades are common hemorrhage, necrosis and due to cytomegalovirus. In the anterior segment is common the infection due to Molluscum contagiosum in the eyelid and cornea. Kaposi's sarcoma is the most common neoplasm, which occurs most commonly as vascular lesions in the bottom of the lower sac. Among the most frequent neuro-ophthalmological conditions in patients with HIV/AIDS, papilledema is associated with cryptococcal meningitis, as the root cause and cerebral toxoplasmosis(AU)
Subject(s)
Humans , Eye Infections/etiology , Acquired Immunodeficiency Syndrome/epidemiologyABSTRACT
Se realizó una revisión bibliográfica con el objetivo de confeccionar un material de apoyo a la docencia, sobre el comportamiento histórico de las principales enfermedades infecciosas que han ocurrido en el territorio nacional desde la época colonial hasta la actualidad. Se abordó el desarrollo de la infectología en Cuba, señalando a las más representativas figuras que se destacaron en este campo de la medicina, así como sus importantes acciones y descubrimientos. Hubo una alta incidencia de las enfermedades infecciosas antes del triunfo revolucionario debido en gran medida a aspectos higiénico- sanitario y a la incapacidad de los gobiernos imperantes para controlar la situación. A partir de 1959, se vio un desarrollo acelerado del sistema de salud que dió definitivamente al traste con aquella triste realidad(AU)
A literature review was made with the aim of building material to support teaching on the historical behavior of the main infectious diseases that have occurred in the country since colonial times to the present. The development of infectious diseases in Cuba, pointing to the most representative figures who stood out in this field of medicine and its important actions and findings were discussed. There was a high incidence of infectious diseases before the Revolution largely due to hygienic conditions and the inability of governments to control the prevailing situation aspects. Since 1959, there was a rapid development of the health system and that definitely gave a different view on that sad reality(AU)
Subject(s)
Humans , Communicable Diseases/history , Public Health/history , Infectious Disease Medicine/history , CubaABSTRACT
Objetivo: El objetivo de este estudio era presentar nuestra experiencia con 2 casos de angiomiolipoma hepático en pacientes con virus de la hepatitis C (VHC) positivo, y realizar una actualización del manejo clínico y tratamiento del angiomiolipoma hepático. Observaciones clínicas: Ambos casos se presentaron en mujeres en la cuarta-quinta décadas de la vida. La presentación clínica fue sintomática en una de ellas e incidental en la otra. Las 2 pacientes presentaban anticuerpos contra el VHC, y se planteó el diagnóstico diferencial con el hepatocarcinoma. Los valores de alfafetoproteína fueron normales. Las pruebas de imagen no fueron concluyentes y sólo la punción-aspiración con aguja fina y la inmunohistoquímica orientaron el diagnóstico de angiomiolipoma. El tamaño de las tumoraciones fue grande: 4,8 y 8 cm de diámetro, respectivamente. En ambos casos se requirió la realización de cirugía exerética para descartar definitivamente la malignidad. No hay evidencia de recidiva tras 6 y 3 años de seguimiento, respectivamente. Discusión y conclusión: El angiomiolipoma es una tumoración hepática benigna poco frecuente, que mimetiza otras lesiones hepáticas. Pese a la dificultad diagnóstica, una serie de datos radiológicos apoyan el diagnóstico de esta enfermedad. No obstante, el diagnóstico definitivo lo proporciona la anatomía patológica y la immunohistoquímica (HMB-45). Se trata de una lesión compuesta por tejido adiposo, células musculares lisas y vasos sanguíneos en diversas proporciones. Pese a su carácter benigno, la dificultad para descartar su malignidad obliga al tratamiento quirúrgico. No está descrita su relación etiopatogénica con el VHC, por lo que consideramos nuestros casos como un hallazgo coincidente
Aim: The aim of this study is to present our experience with two cases of hepatic angiomyolioma in hepatitis C virus (HCV) positive patients, and to up-date the clinical manage, diagnostic and treatment of this entity. Clinical observations: Both cases were presented in women in their 4-5th decade of life. Clinical presentation was with symptoms in one but incidental in the other. Both were HCV positive. Values of alpha-fetoprotein were normal. Radiological imaging was not diagnostic. Histopathological examination and immunohistochemical findings gave the diagnosis angiomyolipoma. At time of diagnosis the size of tumours was 4.8 and 8 cm of diameter. Both cases were treated with surgery in order to definetly discard malignancy. After 6 and 3 years of follow-up, there is no evidence of recurrence. Discussion and conclusion: The hepatic angiomyolipoma is a rare benign tumour, mimicking other liver tumours. Although no patognomonic features, there are some radiological findings that point out to the diagnosis of angiomy olipoma. Nevertheless, definitive diagnosis is done by his tological and immunohistochemical findings (HMB-45). The hepatic angiomyolipoma consists of varing proportion of three elements, mature fat cells, smooth muscle cells and blood vessels. Although it is a bening tumour, the difficulty in discarding malignancy, prompt to surgical management. It is not described its relation with HCV virus, thus we consider our cases as an coincident finding