Spontaneous Regression Of Hepatocellular Carcinoma--a Case Report.
Jang, T. J., Lee, J. I., Kim, D. H., Kim, J. R., & Lee, H. K. (2000). spontaneous regression of hepatocellular carcinoma--a case report. The Korean journal of internal medicine, 15(2), 147–150. https://doi.org/10.3904/kjim.2000.15.2.147
View Original Source →Abstract
Spontaneous regression of cancer is a rare phenomenon seldom described in patients with hepatocellular carcinoma. A 54-year-old Korean woman suffered from cytologically-proved advanced hepatocellular carcinoma, for which she received no treatment. Papanicolaou's smears revealed high cellularity. Many clusters of polygonal cells showed long, thick anastomosing cords covered by flattened endothelial cells. The polygonal cells showed small hepatocytoid appearance, characterized by increased nuclear/cytoplasmic ratio. She remained in good clinical condition and, at 4 years of follow-up, the hepatocellular carcinoma could not be visualized radiologically. To date, only 14 case reports of apparently spontaneous regression of hepatocellular carcinoma have been published in the English literature. The mechanisms underlying this intriguing phenomenon remain unknown.
Case Details
Disease Location
Right hepatic lobe
Personal Characteristics
54-year old female; past medical history includes liver cirrhosis associated with hepatitis b virus
Clinical Characteristics
Presented with burning pain in right upper abdomen for 5 days prior to admission, pain tended to increase when she coughed or took a deep breath, physical exam showed right upper abdomen was tender and irregular hepatomegaly noted 4cm below costal margin, lab results showed leukocytes 7x103 /μl, hemoglobin 8.9 g/dl, hct 25.1%, platelet 123x103/μl, total bilirubin 0.5 mg/dl, serum aspartate transaminase (ast) 55 iu/l, serum alanine transaminase (alt) 44 iu/l, α- fetoprotein (αfp) 3-4 ng/ml, ca19-9 17 u/ml and CEA 6.1 ng/ml\, hepatitis b surface antigen was positive, abdominal ultrasound and CT showed well-circumscribed space-occupying lesion in right hepatic lobe measuring 7cm diameter, cytologic diagnosis was well differentiated hepatocellular carcinoma
Remission Characteristics
Refused any therapy, was admitted 4 years after initial diagnosis for nausea, vomiting and diffuse abdominal pain; physical exam, lab findings, ultrasound and CT showed no evidence of lesion, just vague wedge-shaped area with low density in hepatic dome
Treatment & Mechanisms
Proposed Remission Mechanisms
Cirrhotic changes observed on imaging study could have caused ischemia, contributing to spontaneous regression of tumour