Spontaneous Regression Of A Large Hepatocellular Carcinoma With Multiple Lung Metastases.
Saito, T., Naito, M., Matsumura, Y., Kita, H., Kanno, T., Nakada, Y., Hamano, M., Chiba, M., Maeda, K., Michida, T., & Ito, T. (2014). spontaneous regression of a large hepatocellular carcinoma with multiple lung metastases. Gut and liver, 8(5), 569–574. https://doi.org/10.5009/gnl13358
View Original Source →Abstract
A 75-year-old Japanese man with chronic hepatitis C was found to have a large liver tumor and multiple nodules in the bilateral lungs. We diagnosed the tumor as hepatocellular carcinoma (HCC) with multiple lung metastases based on imaging studies and high titers of HCC tumor markers. Remarkably, without any anticancer treatment or medication, including herbal preparations, the liver tumor decreased in size, and the tumor makers diminished. Moreover, after 1 year, the multiple nodules in the bilateral lungs had disappeared. Fifteen months after the first medical examination, transcatheter arterial chemoembolization (TACE) was performed for the residual HCC. Because local relapse was observed on follow-up computed tomography, a second TACE was performed 13 months after the first one. At 4 years after the second TACE (7 years after the initial medical examination), there was no recurrence of primary or metastatic lesions. Spontaneous regression of HCC is very rare, and its mechanism remains unclear. Understanding the underlying mechanism of this rare phenomenon may offer some hope of finding new therapies, even in advanced metastatic cases.
Case Details
Disease Location
Liver with lung mets
Personal Characteristics
75-year-old man with chronic hepatitis c and diabetes mellitus. No history of alcohol abuse, smoking, blood transfusion, or steroid intake. He took ursodeoxycholic acid for a liver function disorder pointed out 20 years ago.
Clinical Characteristics
1- months history of abdominal pain. P/e revealed hepatomegaly without ascites. Laboratory studies showed elevated levels of liver enzymes and total bilirubin, negative for hepatitis b surface antigen but positive for antibody to hepatitis c virus. Tumour markers associated with hcc were markedly elevated. CT showed a huge heterogeneous dense mass (>20 cm in diameter) with en- hancement involving the right hepatic lobe. CT of the chest revealed multiple nodules in the bilateral lungs of up to 15 mm in diameter. The liver tumour was diagnosed as hcc and the lung masses were diagnosed as hhc metastases
Remission Characteristics
At 3 months after the initial medical examination, the serum tumour markers had decreased markedly. After 9 months, ab- dominal CT revealed that the liver mass had markedly decreased in size and the multiple nodules in the bilateral lungs had disappeared. After 13 months, hcc of 5 cm in size was detected in segment 5/6 of the liver. At 15 months after the first visit, because there was no further decrease in tumour size in the imaging studies and an increase in tumour markers, tace was done with a second one 13 months after.
Treatment & Mechanisms
Clinical Treatment
Transcatheter arterial chemoembolization
Additional Notes
TACE was done a year after diagnosis, during that time the tumour deacresed in size and tumour makes went almost to normal values