Spontaneous Complete Regression Of Multiple Metastases Of Hepatocellular Carcinoma: A Case Report.
Lim, D. H., Park, K. W., & Lee, S. I. (2014). spontaneous complete regression of multiple metastases of hepatocellular carcinoma: A case report. Oncology letters, 7(4), 1225–1228. https://doi.org/10.3892/ol.2014.1869
View Original Source →Abstract
Spontaneous regression of cancer is a partial or complete disappearance of malignant tumor without specific treatment. Spontaneous regression of hepatocellular carcinoma (HCC) is a rare condition, and the mechanism underlying it is unclear. This report presents a rare case of spontaneous complete regression of HCC, as revealed by tumor markers and imaging studies. A 64-year-old Korean male patient with hepatitis B virus-associated chronic hepatitis presented with HCC. The patient had undergone right lobectomy of the liver but the cancer recurred with multiple lung and adrenal metastases after 14 months. The patient received palliative cytotoxic chemotherapy. However, there was no clinical benefit and the disease progressed. It was decided to discontinue anticancer therapy and administer only supportive care. After approximately six months, the symptoms disappeared and the HCC had completely regressed. The patient remains alive over five years after recurrence.
Case Details
Disease Location
Liver + lung & adrenal mets
Personal Characteristics
64-year-old male, previously undergone right lobectomy of liver due to hcc in october 2006, chronic hepatitis b virus carrier
Clinical Characteristics
Presented for treatment of dyspnea and cough 14 months after previous right lobectomy of liver for hcc, CT scan showed multiple lung metastases and left adrenal gland metastasis, elevated serum protein, lab results white blood cell count, 4,970 cells/μl; hemoglobin level, 17.2 g/dl; platelet count, 16.4x104 platelets/μl; aspartate aminotransferase : alanine aminotransferase level, 32:41 iu/l; total bilirubin level, 0.97 mg/dl; gamma guanosine triphosphate level, 17 iu/l; alkaline phosphatase level, 89 iu/l; protein : albumin level, 8.4:4.3 g/dl; prothrombin time (international normalized ratio), 13.2 sec (1.14); α‑fetoprotein (AFP) level, 16.55 ng/ml (normal range, 0‑15 ng/ml); and pivka ii level, 12,900 mau/ml (normal range, 0‑40 mau/ml); after 2 cycles of chemotherapy, disease progressed and patient received 2 more cycles of second-line chemotherapy and then 3 cycles of third line chemotherapy, but disease progressed and treatment was discontinued february 2009
Remission Characteristics
Patient returned for follow-up in may 2009, no change; in september 2009, symptoms had improved and chest regiograph showed that all metastatic nodules had disappeared and serium AFP levels had decreased, regression of hcc tumour observed; CT scan in december 2009 showed that all metastatic nodules in lung and lesions in adrenal glands and lymph nodes had disappeared; follow-up CT scans showed no recurrent lesions and chest radiograph showed no metastatic lesions, serum AFP and pivka ii levels within normal; patient is alive with no symptoms as of may 2013
Treatment & Mechanisms
Clinical Treatment
Palliative chemotherapy with 5-fluorouracil, adriamycin and carboplatin (2 cycles); second-line chemotherapy with 5-flouroracil, etoposide and carboplatin (2 cycles); third line chemotherapy with oral capecitabine
Non-Clinical Treatment
Dendropanax morbifera herbal medicine for one week prior to december 2009 visit