Spontaneous Regression Of Hepatocellular Carcinoma Due To Disrupatiention Of The Feeding Artery.
Okano, A., Ohana, M., Kusumi, F., & Nabeshima, M. (2013). spontaneous Regression of Hepatocellular Carcinoma due to Disrupatiention of the Feeding artery. Case reports in oncology, 6(1), 180–185. https://doi.org/10.1159/000350682
View Original Source →Abstract
We present an unusual case of spontaneous regression of hepatocellular carcinoma (HCC). A 77-year-old man with alcoholic liver cirrhosis presented with a 50-mm tumor in the Couinaud's segment 8 (S8) of the liver, a 15-mm tumor in the S8-7 and 10-mm tumors in the other segments (S4, S6). The tumors were diagnosed as HCC by typical imaging findings and elevated serum alpha-fetoprotein (AFP, 1,825.0 ng/ml) and protein induced by vitamin K absence II (PIVKA II, 3,043 mAU/ml). One month later, AFP and PIVKA II decreased to 51.1 ng/ml and 411 mAU/ml, respectively, and the 50-mm tumor in the S8 became small and completely necrotic on angiography and computed tomography arteriography without any treatment. On the other hand, the 15-mm tumor in the S8-7 decreased in size to 10 mm and received blood supply from the right posterior superior arteries (A7). The other 10-mm tumors remained. Ischemia of the tumors due to disruption of the feeding artery (A8) might have induced tumor regression in the present case.
Case Details
Disease Location
Liver
Personal Characteristics
77-year-old man with alcoholic liver cirrhosis, child-pugh class b. No history of hypertension, diabetes mellitus, and atherosclerosis. He had been a regular drinker, consuming approximately 120 g/day of alcohol every day for 50 years. He had smoked 20 cigarettes per day for 50 years.
Clinical Characteristics
Abdominal us demonstrated a 50-mm hypoechoic mass with a mosaic pattern in s8 and a 15-mm hypoechoic mass in s8-7. Dynamic contrast-enhanced CT showed a partially hypervascular tumour with necrotic area in s8 and a hypervascular tumour in s7-8 ), other 10-mm hypervascular tumours in s6 and s4. Tumour markers levels were high. P/e was unremarkable. Palmar erythema and vascular spider were noted in the skin. The abdomen was soft and flat, and neither masses nor ascites were palpable. He was diagnosed with hcc.
Remission Characteristics
One months after the diagnosis, tumour markers decreased, the mass in s8 decreased to 30 mm and became completely necrotic on CT arteriography. The 15-mm mass in the s8-7 diminished to 10 mm and was described as an enhanced lesion
Treatment & Mechanisms
Proposed Remission Mechanisms
Disrupatiention of the feeding artery associated with angiography or arterial thrombosis
Clinical Treatment
Transcatheter arterial chemoembolization