Spontaneous Regression Of Lung Metastases In Hepatocellular Carcinoma: A Case Report
Muroya, D., Sato, T., Sakai, H., Hisaka, T., Akagi, Y., & Okuda, K. (2021). Spontaneous regression of lung metastases in hepatocellular carcinoma: A case report. International journal of surgery case reports, 78, 378–381. https://doi.org/10.1016/j.ijscr.2020.12.045
View Original Source →Abstract
INTRODUCTION: Spontaneous regression of hepatocellular carcinoma (HCC) is a rare condition. However, although there have been multiple reports of spontaneous regression, the definitive pathogenic mechanism of this phenomenon is still unclear. CASE PRESENTATION: We encountered a case of a 78-year-old man who was undergoing dialysis for end-stage kidney disease with hepatitis C virus-associated chronic hepatitis presenting with HCC. The patient had previously undergone right lobectomy of the liver, but the cancer recurred with multiple lung metastases after 5 months. Approximately 13 months after the initial diagnosis of recurrence, the lung metastases decreased in size and eventually resolved without any anticancer therapy. The patient remains alive for over 41 months after recurrence. DISCUSSION: Based on our case and literature, Hypoxia with hypotension due to hemodialysis can reduce the blood and oxygen supply of the body, which may lead to the spontaneous regression of the metastatic tumors. CONCLUSION: We herein reported a case of spontaneous regression of HCC undergoing dialysis.
Case Details
Disease Location
Lung
Personal Characteristics
78-year-old man. History of hcc due to hepatitis c. End-stage renal disease (esrd) due to diabetes. Hypertension. He had been prescribed metformin, pantoprazole, enalapril, felodipine, and metoprolol.
Clinical Characteristics
The patient underwent right lobectomy of the liver for hcc, and dialysis was initiated after surgery. 5 months after the hepatic resection, computed tomography and chest radiography revealed multiple tumors in the lung, indicating metastatic disease. Pivka-ii was abnormally elevated
Remission Characteristics
13 months later, the metastatic lesions suddenly decreased in size and number. Follow-up imaging showed no evidence of disease progression, and tumor makers were significantly decreased
Treatment & Mechanisms
Proposed Remission Mechanisms
May be attributed to hemodynamic changes associated with dyalisis
Clinical Treatment
Righ hepatic lobectomy, dyalisis