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Unexpected Spontaneous Regression Of Extensively Diffused Hepatocellular Carcinoma

Hirata, T. 2025Liver cancer

Hirata, T., Endo, S., Shirane, N., Kawaguchi, S., & Ohno, K. (2025). Unexpected Spontaneous Regression of Extensively Diffused Hepatocellular Carcinoma. Cureus, 17(2), e79366. https://doi.org/10.7759/cureus.79366

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Abstract

Spontaneous regression (SR) of malignant tumors is defined as the partial or complete reduction of a tumor without medical intervention. This unusual phenomenon has been reported in various types of malignancies. We present a rare case of a 73-year-old woman with untreated chronic hepatitis C who was diagnosed with extensively diffused hepatocellular carcinoma (HCC) accompanied by a tumor thrombus in the left branch of the portal vein. Remarkably, extensive tumor regression occurred under palliative care. This case highlights the potential mechanisms responsible for SR of HCC, including tumor hypoxia, immune activation, and systemic inflammatory responses, and emphasizes the need for further research to clarify these mechanisms.

Case Details

Disease Location

Liver

Personal Characteristics

73-year-old japanese woman with untreated chronic hepatitis c. Smoking history of 37.5 pack-years

Clinical Characteristics

Presented with complaints of abdominal distension and a 5 kg weight loss over the course of one month. CT demonstrated an irregular, cirrhotic liver with a large, 150-mm diffuse hcc replacing the left lobe. The lesion appeared hyperattenuated in the arterial phase and hypodense in the portal venous phase. Multiple smaller hcc lesions were observed in the right lobe, and a tumor thrombus was identified in the left branch of the main portal vein. Tumor markers were markedly elevated. She ceased her 37.5-pack-year smoking habit immediately following her diagnosis of hcc.

Remission Characteristics

Seven months after the initial diagnosis revealed marked regression of the hypervascular hcc. The tumor thrombus in the left branch of the main portal vein had disappeared. Her tumor markers were notably reduced.

Treatment & Mechanisms

Proposed Remission Mechanisms

The tumor thrombus in the left branch of the main portal vein likely caused ischemia and subsequent necrosis of the tumor. Furthermore, the patient’s decision to quit smoking may have reduced oxidative stress and enhanced their natural immune responses against the tumor, contributing to sr. These findings suggest that both tumor hypoxia and immune activation may have played critical roles in the sr

Non-Clinical Treatment

Smoke cessation