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Spontaneous Regression Of Hepatocellular Carcinoma From Autoinfarction And Implications On Liver Transplantation

Singh, K. 2022Liver cancer

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

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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