Two Cases Of Spontaneous Regression Of Multicentric Hepatocellular Carcinoma After Intraperitoneal Rupture: Possible Role Of Immune Mechanisms.
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 →Abstract
We report two cases of spontaneous regression of hepatocellular carcinoma. Firstly, a 64-year-old man with alcohol related cirrhosis developed multiple liver tumours with elevation of the alpha-fetoprotein level at 915 ng/ml. A spontaneous regression of all the tumoural masses but one and normalization of the alpha-fetoprotein level was observed after intraperitoneal spread of the malignancy. Resection of the remaining tumour 9 months later confirmed a hepatocellular carcinoma. Secondly, a 70-year-old woman with alcohol related cirrhosis developed multiple liver tumours with elevation of the alpha-fetoprotein level to 4000 ng/ml; a regression of all the tumoural masses but one and a decrease of the alpha-fetoprotein level to 400 ng/ml was observed after intraperitoneal spread of the malignancy and treatment with tamoxifen. We discuss a possible immune mechanism of tumoural regression with a review of similar cases described in the literature.
Case Details
Disease Location
Liver
Personal Characteristics
Case 2: 70-year-old woman, history of alcoholism
Clinical Characteristics
Pain in the upper right quadrant with mild ascites. CT scan revealed ascites and multiple hyper-enhanced liver tumours involving all segments. AFP level was elevated. The patient was considered to have multicentric hcc and alcoholic cirrhosis.
Remission Characteristics
Ultrasonography 10 months after the diagnosis showed diffuse liver heterogeneity, and 5 months later only one remaining 47 mm tumour in the posterior inferior segment. At that time serum alpha-fetoprotein was decreased. She was admitted to hospital 18 months after the initial diagnosis for massive digestive bleeding related to rupture of oesophageal varices. CT showed ascitis, regression of all liver tumours, with a cystic appearance of al
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Spironolactone and tamoxifen over a period of 18 months. Blood transfusion, an infusion of octreotide and endoscopic ligation of varices (at second hospitalization). Tamoxifen