Spontaneous Regression Of Hepatocellular Carcinoma Confirmed By Surgical Specimen: Report Of Two Cases And Review Of The Literature.
Stoelben, E., Koch, M., Hanke, S., Lossnitzer, A., Gaerightner, H. J., Schentke, K. U., Bunk, A., & Saeger, H. D. (1998). spontaneous regression of hepatocellular carcinoma confirmed by surgical specimen: report of two cases and review of the literature. Langenbeck's archives of surgery, 383(6), 447–452. https://doi.org/10.1007/s004230050158
View Original Source →Abstract
Two cases with spontaneous regression of a histologically confirmed hepatocellular carcinoma (HCC) are presented. This rarely seen phenomenon of a spontaneous tumor involution is discussed and compared with the current literature. The clinical symptoms were very similar to that of a liver abscess. A 56-year-old male suffered from a multicentric, highly differentiated, trabecular HCC. First symptoms were epigastric pain, septic fever and arthritis. The tumor marker AFP was constantly normal and no hepatitis could be verified. A resection of the tumor was performed. In patient 2, a 74-year-old male, a multicentric, clear cell HCC was found. The patient had completely recovered from hepatitis type B and within the liver tissue no viruses could be identified. Clinical symptoms were mainly characterized by upper abdominal pain and septic fever. AFP was excessively elevated (3850 ng/ml) but returned to normal preoperatively. In both cases, the specimen showed a subtotal necrotic HCC with insignificant amounts of vital tumor cells. Neither patient had a liver cirrhosis macroscopically, however patient 2 had local periportal fibrosis histologically. After 24 and 41 months of follow-up, respectively, both patients are in good health
Case Details
Disease Location
Liver
Personal Characteristics
74-year-old male
Clinical Characteristics
Admitted to our hospital for surgical ther- apy of an unclarified tumor inside the liver, in march 1995. Fever up to 39.0 c and a painful swelling below the right costal arch had be- gun 3 months earlier. AFP was elevated, hep b positive. Us depicted an irregularly marked, echogenic tumor of 6 cm in diameter inside segment vi. CT of the upper abdomen showed a hypodense tumor of 5×5x3 cm in size with a capsule. The patient was admitted to our hospital 3 months after the onset of symptoms. The patient still reported slight epigastric pain. The tumor was finally removed by surgical resection of segment vi,
Remission Characteristics
Us, during second addition, showed tumor size was 2.5 cm. Angiography and staging investigations did not show pathologic findings. Histologic assessment showed totally necrotic tumor tissue with small islets of a clear cell primary liver cell carcinoma, demarcated by granulated tissue rich in foam cells
Treatment & Mechanisms
Proposed Remission Mechanisms
Tumor regression due to immune stim- ulation
Clinical Treatment
Surgical resection of segment vi,
Non-Clinical Treatment
Extract of radix urighticae