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Clear Cell Carcinoma Of The Liver With Spontaneous Regression Of Metastases.

Mcdermott & Khettry, 1994Liver cancer

McDermott, W. V., & Khettry, U. (1994). Clear cell carcinoma of the liver with spontaneous regression of metastases. Journal of surgical oncology, 57(3), 206–209. https://doi.org/10.1002/jso.2930570315

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Abstract

The purpose of this report is to establish in some detail a case of spontaneous regression of metastases secondary to a clear cell hepatocellular carcinoma. A review of the hepatocellular carcinomas from this department has been previously reported, and this particular study focuses on the two lesions that have the microscopic classification referred to above. One young female patient was 23 at the time of resection of the clear cell carcinoma of the liver plus diffuse intrahepatic metastases. She has been followed carefully over the years and has been seen as recently as June 1993. At that time, studies including ultrasonic and CT scan examinations of liver were carried out, all of which were negative for any evidence of residual disease. The evidence presented in this report would seem to establish conclusively that a spontaneous regression of the metastases from a clear cell carcinoma of the liver had occurred without any medication and without any obvious alteration in diet or state of health. © 1994 Wiley‐Liss, Inc.

Case Details

Disease Location

Liver + both liver lobes mets

Personal Characteristics

23 -year-old WHO had been in excellent general health until february 1973, she had not taken birth con- trol pills or any other hormonal medication, and there was absolutely no significant medical or dietary adjunct or variant

Clinical Characteristics

February 1973, she first noticed mild discomfort in the upper abdomen and was able to palpate a nontender firm mass on examination, a large, smooth mass was palpable in the epigastrium and right upper quadrant. There were no abnormalities in blood or urine studies. Specifically, liver function tests were all within normal limits. Liver scan showed a large filling defect in the left lobe of the liver. Hepatic arteriogram (fig. La) showed a large hypervascular mass involving the left lobe, including the medial segment. The capillary phase showed nodular irregularities at the peripheral margin of the main mass. A right hepatic arteriogram did not show hypervascular tumour deposits(fig. Lb,c). Laparotomy on may 3, 1973. Exploration of the abdomen was entirely negative except for the liver, where a large tumour mass measuring 12-15 cm in diameter occupied the medial portion of the left lobe. Biopsy was interpreted as consistent with intrahepatic metastasis.

Remission Characteristics

She was last seen in the office in may of 1993, 20years after resection of a primary clear cell carcinoma of the liver with diffuse metastatic nodules of the microscopically proven tumour throughout both lobes of the liver. Recent cat scan and ultrasound study of the liver have been carried out and show no evidence of residual or metastatic disease, except for mild diabetes, which is under control, she remains in excellent health in every respect.

Treatment & Mechanisms

Proposed Remission Mechanisms

Either regression or differentiation and maturation into normal hepatocytes.

Clinical Treatment

Left hepatic lobectomy