Spontaneous Regression Of Hepatocellular Carcinoma Is Possible And Might Have Implications For Future Therapies.
Randolph, A. C., Tharalson, E. M., & Gilani, N. (2008). spontaneous regression of hepatocellular carcinoma is possible and might have implications for future therapies. European journal of gastroenterology & hepatology, 20(8), 804–809. https://doi.org/10.1097/MEG.0b013e3282f2bbcc
View Original Source →Abstract
Hepatocellular carcinoma is a potentially challenging cancer with very high mortality. Medical therapies are generally ineffective in achieving complete remission, especially for aggressive types or for advanced stage cancers. Spontaneous regression of these tumors is a rare and fascinating phenomenon. We describe such a patient with spontaneous regression of a large multi-focal hepatocellular carcinoma, and present a comprehensive review of the reported cases with a special emphasis on potential regression mechanisms.
Case Details
Disease Location
Liver
Personal Characteristics
56-year-old caucasian man, chronic HCV infection for 2 years. History of emphysema, hypertension, and gastroesophageal reflux. Tattoo 7 years before. 40 pack-year history of smoking and had consumed five to six beers daily for 40 years. Carpenter
Clinical Characteristics
Bdominal pain and a palpable lump in the abdomen. Abdominal examination demonstrated a palpable firm mass in the epigastric area. AFP levels were markedly elevated. HBV seroconversion, HCV infection. An ultrasound revealed a large left hepatic lobe mass, and an echogenic thrombus distending the main portal vein. A contrast-enhanced computed tomography (CT) scan showed a 7.5-cm heterogeneous mass in the lateral segment of the left hepatic lobe, a thrombus in the left portal vein, and fatty infiltration and suspicion of multiple tumor foci in the right lobe. CT-guided biopsy of the mass was obtained; histology and immuno-reactive stains were consistent with poorly differentiated hcc.
Remission Characteristics
35 days later, the previously palpated mass had resolved. A complete blood count was normal, and AFP had returned to normal
Treatment & Mechanisms
Proposed Remission Mechanisms
Exaggerated immune response or a compromised tumoral blood supply could explain the regression
Clinical Treatment
Bronchodilator inhalers, diltiazem, propranolol, and omeprazole.