Spontaneous Regression Of A Large Hepatocellular Carcinoma With Portal Vein Tumour Thrombi: Report Of A Case.
Uenishi, T., Hirohashi, K., Tanaka, H., Ikebe, T., & Kinoshita, H. (2000). spontaneous regression of a large hepatocellular carcinoma with portal vein tumor thrombi: report of a case. Surgery today, 30(1), 82–85. https://doi.org/10.1007/PL00010054
View Original Source →Abstract
A 65-year-old man with chronic hepatitis C showed a markedly elevated serum alpha-fetoprotein concentration. Computed tomography revealed a huge tumor occupying the entire right hepatic lobe. Three months later, the tumor regressed spontaneously from 12 cm to 7 cm in diameter without any medical treatment. A right hepatic lobectomy was performed 4 months after the initial diagnosis. The main tumor, located in the posterior inferior segment, was completely necrotic, and had a thick fibrous capsule. Many inflammatory cells had also infiltrated into the tumor. Only a small portion of a tumor thrombus in the portal vein and one of three intrahepatic metastases contained viable cancer cells. The tumor was found to be poorly differentiated hepatocellular carcinoma. Tumor regression may have been caused by a disturbance in hepatic circulation associated with the portal vein thrombus.
Case Details
Disease Location
Liver
Personal Characteristics
65-year-old japanese man, no notable family history. Hisotry of dm and chronic hepatitis secondary to daily alcohol usage for 40 year.
Clinical Characteristics
High serum AFP was noted during routine check-up. Liver us/CT revealed a tumour (12cm) occupying the entire right hepatic lobe. 3 months later he was addmited to the hospital with p/e shwoing hepatomegally, HCV postivie, AFP and pivka ii were elevated.
Remission Characteristics
A 1 year later follow up CT showed the hepatic mass to have deceased to 7cm in diameter. An arterial porightogram demonstrated a complete obstruction of the right posterior branch of the portal vein. Biopsy of the especimen retrieved from the lobectomy, demonstrated a necrotic core of the mass with a thick capsule.
Treatment & Mechanisms
Proposed Remission Mechanisms
Disturbance in both the portal venous and hepatic artery flow
Clinical Treatment
Hepatic lobectomy 1 year after diagnosis