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Hepatocellular Carcinoma: Misdiagnosis Or Spontaneous Remission?

Stefanczyk-Sapieha, L. 2008Liver cancer

Stefanczyk-Sapieha, L., & Fainsinger, R. L. (2008). Hepatocellular carcinoma: misdiagnosis or spontaneous remission?. Journal of palliative care, 24(1), 55–59. https://doi.org/10.1177/082585970802400108

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Case Details

Disease Location

Liver

Personal Characteristics

56-year-old man, chronic alcohol abuse, hepatitis c, type 2 diabetes, heavy smoking, depression, and antisocial patterns of behaviour

Clinical Characteristics

Admitted to the palliative care unit with a diagnosis of agitated delirium and terminal hcc (diagnosed 32 months earlier), significantly elevated AFP. MRI of the was found to have lesions highly suggestive of hcc infiltration, predominantly in the right lobe of the liver. Biopsy revealed cirrhosis g3.

Remission Characteristics

MRI of the abdomen was repeated and results were compared with previous findings. A shrunken cirrhotic liver was found, with evi- dence of portal venous hypertension, including splenomegaly and ascites. The previously identi- fied enhancing areas of the left lobe of the liver, suspicious for hcc, were no longer present.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Opioids (palliative care) haloperidol, olanzapine, zuclopenthixol, trazadone, quetiapine, methotrimeprazine, and was then started on a subcutaneous infusion of midazolam. (for delirium)

Additional Notes

Misdiagnosis or SR?? could be any