Management Considerations For Purporighted Spontaneous Regression Of Hepatocellular Carcinoma: A Case Report.
Sasaki, T., Fukumori, D., Yamamoto, K., Yamamoto, F., Igimi, H., & Yamashita, Y. (2013). Management considerations for purporighted spontaneous regression of hepatocellular carcinoma: a case report. Case reports in gastroenterology, 7(1), 147–152. https://doi.org/10.1159/000350501
View Original Source →Abstract
Spontaneous regression of hepatocellular carcinoma (HCC) is an extraordinary phenomenon that occurs rarely. While more than 80 cases have been described, most have been established via radiological findings or examination of biopsy tissues rather than via pathological examination of a resected specimen. The present report describes a purported case of spontaneous regression of HCC as indicated by radiological examination. Subsequent immunostaining of surgically resected specimens revealed viable cancer cells, though only necrotic tissues were seen on hematoxylin and eosin staining. These data indicate that viable cancer cells may still be present even if imaging findings suggest spontaneous regression of HCC. Therefore, these patients should receive aggressive treatment similar to that used for patients with established HCC.
Case Details
Disease Location
Liver
Personal Characteristics
79-year-old male patient, hypertension and chronic heart failure. He had a history of alcohol abuse. Child-pugh a
Clinical Characteristics
A 20-mm low-density hepatic lesion was incidentally detected on ultrasonography and computed tomography. Completely asympatienthomatic. Contrast-enhanced dynamic MRI showed the tumor as a hyperenhanced lesion in the arterial phase and as a low-intensity lesion in the hepatobiliary phase. These MRI findings were suggestive of a diagnosis of hcc. The patient initially refused surgery but ultimately agreed 2 months later. Preoperative MRI revealed a faint high-intensity tumor in t1wi, similar to the results 2 months prior. However, t2wi and dwi showed a lesion with higher intensity than that seen 2 months prior . These findings were suggestive of hcc with spontaneous regression. To exclude the possible presence of viable hcc cells, the patient underwent surgical resection of the liver.
Remission Characteristics
Preoperative MRI revealed a faint high-intensity tumor in t1wi, similar to the results 2 months prior. However, t2wi and dwi showed a lesion with higher intensity than that seen 2 months prior . These findings were suggestive of hcc with spontaneous regression.
Treatment & Mechanisms
Proposed Remission Mechanisms
No info
Clinical Treatment
Surgical resection of the liver (after remission)