Spontaneous Regression Of Hepatocellular Carcinoma: A Case Study
Cancer 50(2): July 15 1982; 332-336
View Original Source →Abstract
The infantile hemangioendothelioma of the liver is a rare and unique abdominal tumor of infancy. It resembles the common hemangioma of the skin, and may, like that lesion, have a natural course of rapid growth, followed by spontaneous regression and complete cure if its infant host survives. Recognition of the tumor and appropriate therapy are therefore of extreme importance. The usual presenting features are similar to those of other abodminal tumors but the unique capacity of this lesion to produce cardiac failure should lead one to suspect its presence when suspicion of congenital heart disease cannot be confirmed. Angiomata of the skin apparently have little diagnostic value except as a reminder that an angiomatous tumor of the liver may occur. Jaundice is probably a poor prognostic sign. Treatment of choice is surgical removal, but the majority of cases are not susceptible to this approach either because of diffuse involvement of the liver or because of involvement of major hilar structures by a solitary mass. In this event, roentgen ray therapy may offer a suitable alternative. Three cases of infantile hemangioendothelioma of the liver are reported, one with spontaneous regression. In two cases there was cardiac hypertrophy, dilatation and failure, presumably due to arteriovenous shunting within the tumor.
Case Details
Personal Characteristics
A 50-year-old male carpenter from southern china
Clinical Characteristics
Progressive distending discomfort in the epigastrium for one month, enlarging epigastric mass for two weeks, reduced food intake, weight loss of 3 kilograms, jaundice, finger clubbing, ankle oedema, hard nodular hepatomegaly, fetor hepatic, ascites, palmar erythema, persistent fever of 38°c
Remission Characteristics
Epigastric distension decreased, liver decreased progressively in size, fluid retention disappeared, no clinical evidence of hcc, minimal biochemical abnormalities, no dysplasia, no clinical or biochemical evidence of liver cirrhosis, no feature of residual hcc, asymptomatic, and apparently free from recurrence
Treatment & Mechanisms
Proposed Remission Mechanisms
Regression of hcc might occur by involution rather than maturation, regressed hcc might be replaced by surrounding tissue instead of leaving behind dysplasia
Clinical Treatment
Methylclothiazide was administered for ankle oedema, administration of tetracycline and later chloramphenicol and streptomycin
Non-Clinical Treatment
Chinese herbal medicine
Additional Notes
The patient had a history of suspected pulmonary tuberculosis. He had no known history of previous hepatitis or androgen intake. He had been taking Chinese herbal medicine. His food habits were not noticeably different from before. The recipe of Chinese herbs that he took was subsequently tried by us on about 20 consecutive patients with HCC. No detectable regression of tumor was observed in any patient.