spontaneous regression of hepatocellular carcinoma: report of a case.

Abstract

The widespread use of ultrasound in screening programmes for chronic liver disease has led to early diagnosis of hepatocellular carcinoma (HCC), and to the observation of some cases of tumour spontaneous regression. This is a rare event whose underlying mechanism is still unclear. We present here a case of spontaneous regression of HCC in a 71-year-old woman with chronic hepatitis and discuss possible aetiologies. None of the causative mechanisms proposed for spontaneous regression of HCC is completely satisfactory, so further studies are necessary to improve understanding of this unusual biological event. Therefore, we stress the importance of accumulating all such cases in the literature, because the clarification of aetio-pathogenic mechanisms may lead to the development of new treatment strategies for HCC.

Case Details

Disease Location

Liver

Personal Characteristics

71-year-old woman, HCV chronic infection of 8 years without any special treatment. No past medical and family history of note and did not smoke or drink

Clinical Characteristics

Abdominal us showed a 4cm mass in the liver. At pe, the patient appeared in good health and neither liver nor any other mass was palpated in the abdomen. Laboratory tests on admission revealed elevated tumour markers. Abodminal CT showed a space-occupying lesion of 4 cm in s3. Therefore diagnosed with hcc. She was planned for surgery. During the pre-operative us, thrombosis of the portal branch of segments 3-4 was demonstrated. Thus contraindicated surgery.

Remission Characteristics

Three months later, a repeat abdominal ultrasound demonstrated a shrinkage of the hepatic lesion and thrombosis of the feeding artery. CT scan showed only vague signs of a hepatic tumour, and the serum AFP level was in the normal range

Treatment & Mechanisms

Proposed Remission Mechanisms

Tumour infarction secondary to vascular occlusion