Spontaneous Regression Of Hepatocellular Carcinoma From Autoinfarction And Implications On Liver Transplantation
Singh K. (2022). Spontaneous Regression of Hepatocellular Carcinoma From Autoinfarction and Implications on Liver Transplantation. ACG case reports journal, 9(7), e00825. https://doi.org/10.14309/crj.0000000000000825
View Original Source →Abstract
Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide. Spontaneous regression of HCC due to autoinfarction is rare. This case series describes 2 cases of HCC autoinfarction that affected transplant candidacy: 1 patient previously ineligible because of tumor size and not meeting the Milan criteria became eligible after autoinfarction and tumor shrinkage while the second one was delisted in the view of improved symptoms of chronic liver disease and significant HCC regression. These cases provide an opportunity to review the pathogenesis of HCC autoinfarction and to remind practitioners of how this entity might alter decision-making around transplant eligibility.
Case Details
Disease Location
Liver
Personal Characteristics
54-year-old man. History of cirrhosis due to hepatitis b. Hcc found in segment 7 and treated successfully with transarterial chemoembolization 4 months before presentation
Clinical Characteristics
Presented with decompensated cirrhosis with ascites, hepatic encephalopathy, and esophageal varices. The patient underwent MRI surveillance for hcc that revealed a new, 5.2 x 4.8 cm segment 4 lesion
Remission Characteristics
One month later, a triple-phase computed tomography scan showed tumor shrinkage to 4.5 x 3.2 cm, suggestive of autoinfarction
Treatment & Mechanisms
Proposed Remission Mechanisms
It is possible that the tumor regressed because of it outgrowing its blood supply