Spontaneous Regression Of Hepatocellular Carcinoma Repeated 3 Times With Invasion Of Portal Vein And Inferior Vena Cava: Report On A Rare Case.

Komatsu, H. 2012Liver cancer

Komatsu, H., Imamura, S., Shimizu, T., Tsunoda, Y., Ito, T., Imai, J., Nagakubo, S., Morohoshi, Y., & Fujita, Y. (2012). spontaneous regression of hepatocellular carcinoma repeated 3 times with invasion of portal vein and inferior vena cava: report on a rare case. Clinical journal of gastroenterology, 5(1), 35–41. https://doi.org/10.1007/s12328-011-0266-1

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Abstract

A 65-year-old man suffered from advanced hepatocellular carcinoma in the right lobe of the liver, for which he received no treatment. His serum was positive for hepatitis C antibody. In spite of his poor prognosis, he remained in good clinical condition and at 6-month follow-up the tumor had regressed without specific treatment, as assessed both radiologically and from a decrease of a previously elevated serum tumor marker level (1st regression). The tumor regrew in size, but at 23-month follow-up could no longer be visualized radiologically (2nd regression). A follow-up computed tomography (CT) scan did not show any relapse of hepatocellular carcinoma until March 2005. At that time, a new lesion had developed in the caudate lobe and tumor size had increased to ≥10 cm in diameter, and in June 2006 had invaded the portal vein and inferior vena cava. Afterwards, the tumor lesion gradually decreased again. In June 2007, a CT scan showed a further reduction of tumor size (3rd regression). Here, we report a rare case of spontaneous regression of hepatocellular carcinoma in which spontaneous regression and recurrence were repeated 3 times.

Case Details

Disease Location

Liver

Personal Characteristics

65-year-old man, one episode of duodenal bulb ulcer 35 years earlier

Clinical Characteristics

2- months history of upper abdominal dis- comforight and an approximate weight loss of 5 kg with nausea, but no vomiting. His appetite deteriorated and he became increasingly jaundiced with dark urine associated with increasing itchiness. Pe irregular hepatomegaly was noted 4 finger-breadths below the costal margin without ascites. Laboratory tests showed, elevated alkaline phophatase and pivka-ii, normal AFP, positive HCV. CT demonstrated a heterogeneously enhanced tumor lesion in the right lobe of the liver. He was diagnosed with a massive hcc with portal and hepatic vein tumor invasion. One year after remission, a new hcc lesion, 5 cm in diameter in s1 was found. Afterwards, hcc recurred 3 times; however, he received treatment with tace each time and was alive in good condition in february 2011.

Remission Characteristics

6 months later, early-phase contrast-enhanced CT showed a high-density tumor in s7, the diameter of the tumor was 3–4 cm and the tumor volume had decreased remarkably compared to the previous CT. 2 years after diagnosis, serum concentration of pivka-ii had decreased dramatically. In addition, a CT scan confirmed that the tumor had completely disappeared