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Spontaneous Regression Of Hepatocellular Carcinoma.

Kaczynski, J. 1998Liver cancer

Kaczynski, J., Hansson, G., Remotti, H., & Wallerstedt, S. (1998). spontaneous regression of hepatocellular carcinoma. Histopathology, 32(2), 147–150. https://doi.org/10.1046/j.1365-2559.1998.00340.x

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Abstract

AIMS: To determine the clinical and histopathological features of a case of a spontaneous regression of hepatocellular carcinoma (HCC). CASE DETAILS: HCC was found incidentally in a 73-year-old man during a laparotomy for evaluation of gastric retention. Despite no treatment being given, he improved gradually with no sign of tumour as evidenced by coeliac angiography 15 months later, as well as by explorative laparotomy after another 2 years. The patient died 15 years after the primary diagnosis of HCC, without known evidence of tumour recurrence. The patient's clinical records were reviewed, and paraffin-embedded liver tissue was re-evaluated. Both histological and immunohistochemical features were compatible with the diagnosis of a well differentiated HCC. Conceivable causes of the spontaneous regression of this and other reported cases are discussed, but the phenomenon remains enigmatic. CONCLUSIONS: This case with a histologically proven HCC and a very long follow-up time confirms that spontaneous regression does occur. Since the case was found incidentally our report also implies that this may not be as rare as reported.

Case Details

Disease Location

Liver

Personal Characteristics

73-year-old man, use of digitalis for treatment of transient dysrhythmia.

Clinical Characteristics

Presented with a duodenal ulcer with gastric retention. During the laparotomy a hepatic tumour, < 70 mm in diameter, situated in the hilum, was discovered. Biopsy from the liver, however, showed well differentiated hcc in a non-cirrhotic liver. After 2 years the patient presented with haematemesis. An explorative laparotomy was performed with no evidence of either a pancreatic or hepatic tumour. A second wedge biopsy from the liver showed mild steatosis.

Remission Characteristics

Coeliac angiography was performed 15 months later; no tumour was seen.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Gastro-enteric anastomosis