Spontaneous Regression Of Hepatocellular Carcinoma-a Case Report.
Blondon, H., Fritsch, L., & Cherqui, D. (2004). Two cases of spontaneous regression of multicentric hepatocellular carcinoma after intraperitoneal rupture: possible role of immune mechanisms. European journal of gastroenterology & hepatology, 16(12), 1355–1359. https://doi.org/10.1097/00042737-200412000-00020
View Original Source →Case Details
Disease Location
Liver
Personal Characteristics
61-year-old male, full-time engineer, type 2 diabetes mellitus and hypertension, and was also being worked up for aortic valve replacement for severe aortic stenosis, he was on metformin, acute myeloid leukemiaodipine, aspirin, ramipril, insulin, and simvastatin
Clinical Characteristics
Referred to the hepatology clinic by his general practitioner for consideration of hepatitis c treatment, being infected with genotype 1b virus, no clinical suggestion of cirrhosis or portal hypertension. Three years later he reconsulted and started anti-viral. He was noted to have ascites and bipedal edema but no other clinical changes. Baseline investigation showed good liver synthetic function. AFP was significantly raised. CT of the liver showed that his liver was enlarged and heterogeneous, consistent with cirrhosis. Portal vein was patent, and a hypodense lesion was identified in segment 5 of the liver with peri-aortic lymphadenopathy. He was planned for chemotherapy. Baseline assessment before starting chemotherapy unexpect- edly showed AFP 6 with staging CT showing significant reduction in tumour bulk and peri-aortic lymphadenopathy and confirming ascites. 22 weeks later, the AFP had gone up to 7600 with CT showing clear evidence of enlarging liver primary lesion and the peri-aortic lymph node mass. He was finally accepatiented for sorafenib therapy. He finally died.
Remission Characteristics
Follow-up CT five months later showed continued regression of tumour and lymphadenopathy; however, the AFP level was margin- ally higher at 19
Treatment & Mechanisms
Proposed Remission Mechanisms
Tumour tissue-specific immune-mediated mechanism
Clinical Treatment
Furosemide and spironolactone. Sorafenib (after recurrence)