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Spontaneous Regression Of Hepatocellular Carcinoma: When The Immune System Stands Up To Cancer

Arjunan, V. 2021Liver cancer

Arjunan, V., Hansen, A., Deutzmann, A., Sze, D. Y., & Dhanasekaran, R. (2021). Spontaneous Regression of Hepatocellular Carcinoma: When the Immune System Stands Up to Cancer. Hepatology (Baltimore, Md.), 73(4), 1611–1614. https://doi.org/10.1002/hep.31489

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Abstract

Spontaneous regression of cancer is rare and has been observed mostly in immunogenic cancers like melanoma. A few cases of spontaneous regression of hepatocellular carcinoma (HCC) have been reported, but the mechanisms of regression have not been elucidated. Here, we report a patient with advanced HCC who experienced spontaneous regression of her tumor and present evidence for a putative immunemediated mechanism for tumor regression.

Case Details

Disease Location

Liver

Personal Characteristics

65-year-old female

Clinical Characteristics

Alcohol-associated cirrhosis diagnosed with infiltrative 17 cm hcc with occlusive portal vein tumor thrombus and serum alpha-fetoprotein (AFP) of 40,250 ng/ml. The patient mentioned taking a pneumococcal vaccine prior to presentation

Remission Characteristics

Before treatment was initiated, she showed a spontaneous decrease in serum AFP to 250 ng/ml. Magnetic resonance imaging (MRI) showed complete involution of both the primary tumor and the portal vein tumor thrombus.

Treatment & Mechanisms

Proposed Remission Mechanisms

Specific mechanisms of immune surveillance. Host immune responses can at times successfully target hcc

Clinical Treatment

Pneumococcal vaccine