Spontaneous Regression Of A Large Hepatocellular Carcinoma With Skull Metastasis.
Nam, S. W., Han, J. Y., Kim, J. I., Park, S. H., Cho, S. H., Han, N. I., Yang, J. M., Kim, J. K., Choi, S. W., Lee, Y. S., Chung, K. W., & Sun, H. S. (2005). spontaneous regression of a large hepatocellular carcinoma with skull metastasis. Journal of gastroenterology and hepatology, 20(3), 488–492. https://doi.org/10.1111/j.1440-1746.2005.03243.x
View Original Source →Abstract
Spontaneous regression of hepatocellular carcinoma (HCC) is a rare phenomenon. This case of a 65-year-old Korean man with HCC and metastatic frontal bone mass that regressed after radiotherapy for frontal bone mass without any other therapeutic modalities is described. The clinical diagnosis of HCC was made because of the presence of a liver mass on abdominal computed tomography (CT) scan, high serum alpha-fetoprotein value and tissue diagnosis on frontal bone biopsy. The patient refused any other recommended treatments, but accepted the radiation therapy due to a painful frontal bone mass, and ingested mushroom called Phellinus linteus for one and a half years. Ten months after radiation therapy, he experienced a reduction in size of the frontal bone mass and improvement of lesions in the liver, sternum and ribs. The patient is alive and in good condition without any symptoms or tumor aggravation in August 2002. It was concluded that a rare case of spontaneous regression of HCC had occurred.
Case Details
Disease Location
Liver + skull mets
Personal Characteristics
65-year-old korean man, 100 g of alcohol per day for 30 years
Clinical Characteristics
Complaining of a frontal mass for 1 year. He reported that the frontal mass had grown larger over the previous 6 months. On admission, physical examination disclosed a huge, hard and unmovable frontal mass of skull, and abdominal palpation showed that the liver edge was palpable about 5 cm below the right costal margin of the rib cage. Laboratory examination revealed mild hepatic dysfunction. HCV tested positive. CT of the skull showed a huge, bulging mass of the frontal skull. Us and CT of the liver showed a multinodular, huge mass of the nearly entire right lobe of the liver. Whole body bone scan disclosed the multiple metastases not only in the hot uptakes of the frontal skull region but also in the 3–5 and 6th ribs and sternum. A biopsy of the frontal skull mass reported a metastatic hcc.
Remission Characteristics
Ten months after radiation therapy, the follow-up CT revealed a marked reduction in the size of the hepatic mass and a reduction in the number of nodules. In addition, a fol- low up whole body bone scan also showed an absence of the previous hot uptakes of the ribs, sternum and a reduced uptake of the skull lesion
Treatment & Mechanisms
Proposed Remission Mechanisms
First, a rapid expansion of the hepatic and skull masses induced necrosis of the tumors or a portal vein occlusion. Second, radiation therapy toward the skull mass induced a delayed abscopal phe- noumenon that reduced the remote original hepatic masses. Third, the ingestion of phellinus linteus and/or radiation therapy may have affected the regression pro- cess simultaneously or separately by immunological modulation due to some unknown mechanisms.
Clinical Treatment
Radiation therapy
Non-Clinical Treatment
Agaricus (phellinus linteus)