Spontaneous regression of hepatocellular carcinoma.

Ayres, R. C. S.; Robertson, Deborah; Dewbury, K. C.; Millward-Sadler, G. H.; Smith, Carl C.

doi:10.1136/gut.31.6.722

Cited by 36 publications

(23 citation statements)

References 15 publications

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“…Some authors have reported spontaneous regression of the lesions in both the liver and metastatic organs [10, 12, 17]. Therefore, ischemic effects alone could not fully explain the complete necrosis of the tumor in our case.…”

Section: Discussionmentioning

confidence: 57%

“…The precise mechanism of spontaneous regression of HCC is speculative, with five mechanisms suggested: (1) immune mechanism, with relation to the excessive production of cytokine because of infection, hemorrhage or ischemia [7, 12]; (2) endocrine factors, with withdrawal of the androgen therapy [13]; (3) perfusion injury, gastrointestinal bleeding or spasm of hepatic artery deduces the supply to the tumor [14, 16]; (4) physical and mental conditions, with reducing physical or mental stress [15], and (5) herbal medicine [17]. The genesis, however, has not been clearly concluded [4].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Necrosis of Hepatocellular Carcinoma: A Case Report

Morimoto

Tanaka²,

Itoh³

et al. 2002

Dig Surg

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Background: Spontaneous regression of a malignant tumor is a rare phenomenon. So far, 13 cases of spontaneous regression of hepatocellular carcinoma (HCC) have been described in the English literature. We report a case of HCC, with spontaneous complete necrosis demonstrated by histological examination. Methods: A 73-year-old male was admitted to our hospital complaining of general fatigue. CT and US revealed a huge mass measuring 9.5 cm at the left lobe. Angiographies showed hypovascular tumor stains. The levels of alpha-fetoprotein (AFP) and PIVKA-2 on admission were high, at 55 ng/ml and 62,300 mAU/ml, respectively. We diagnosed hypovascular HCC and performed a left lobectomy on October 16, 2000. Results: In the histological examination, no viable cells were found. The levels of AFP and PIVKA-2 had already decreased to 14 ng/ml and 1,420 mAU/ml, before laparotomy. Conclusion: Changes in tumor markers and histological findings reveal that this phenomenon occurred without specific treatment.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Spontaneous Necrosis of Hepatocellular Carcinoma: A Case Report

Morimoto

Tanaka²,

Itoh³

et al. 2002

Dig Surg

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“…Nineteen cases of spontaneous HCC regression have been reported in the English-language literature, [1][2][3][4][7][8][9][10][11][12][13][14][15][16][17][18][19] and it is speculated that necrosis, caused by an ischemic disorder, and tumor immune activation are important causal factors. When we evaluated the causes of spontaneous regression in the 19 patients reported, 5 involved necrosis, 1,2,7-9 and 8 involved immunity.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous regression of recurrent hepatocellular carcinoma after TAE: possible mechanisms of immune mediation

Nakai¹,

Shimomura²,

Hirokawa³

2001

Int J Clin Oncol

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We report findings in a 76-year-old man who underwent a lateral segmentectomy of the liver for hepatocellular carcinoma in July 1996. In July 1997, transarterial embolization (TAE) was performed for recurrent tumors in the remnant liver. Augmentation of the tumors and an increase in protein induced by vitamin K absence or antagonist (PIVKA)-II level were noted in October 1997, and, although we recommended TAE again, the patient and his family refused further treatment. Subsequently, the patient was only observed, and, except for a small lesion that was probably a scar, no tumors were noted on image examinations in November 1998, and the PIVKA-II level had returned to a normal value at this time. Two years after the regression, the tumors appeared to be in complete spontaneous remission. This patient had no history indicative of ischemic necrosis, and levels of cellular surface markers for natural killer (NK) cells and NK cell activity showed high values, which suggested that tumor immunity was activated by some, unknown, mechanism.

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“…In the literature it is referred to in more than 20 cases [11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. However, the cause of spontaneous remission is not known.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous regression of hepatocellular carcinoma confirmed by surgical specimen: report of two cases and review of the literature

Stoelben

Koch

Hanke

et al. 1998

Langenbeck's Archives of Surgery

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Two cases with spontaneous regression of a histologically confirmed hepatocellular carcinoma (HCC) are presented. This rarely seen phenomenon of a spontaneous tumor involution is discussed and compared with the current literature. The clinical symptoms were very similar to that of a liver abscess. A 56-year-old male suffered from a multicentric, highly differentiated, trabecular HCC. First symptoms were epigastric pain, septic fever and arthritis. The tumor marker AFP was constantly normal and no hepatitis could be verified. A resection of the tumor was performed. In patient 2, a 74-year-old male, a multicentric, clear cell HCC was found. The patient had completely recovered from hepatitis type B and within the liver tissue no viruses could be identified. Clinical symptoms were mainly characterized by upper abdominal pain and septic fever. AFP was excessively elevated (3850 ng/ml) but returned to normal preoperatively. In both cases, the specimen showed a subtotal necrotic HCC with insignificant amounts of vital tumor cells. Neither patient had a liver cirrhosis macroscopically, however patient 2 had local periportal fibrosis histologically. After 24 and 41 months of follow-up, respectively, both patients are in good health

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Spontaneous regression of hepatocellular carcinoma.

Abstract: A 63 year old white woman presented with abdominal discomfort, anorexia, and weight loss. Investigations showed hepatocellular carcinoma with pulmonary metastases. The primary and secondary tumours resolved without specific treatment.

Cited by 36 publications

References 15 publications

Spontaneous Necrosis of Hepatocellular Carcinoma: A Case Report

Spontaneous Necrosis of Hepatocellular Carcinoma: A Case Report

Spontaneous regression of recurrent hepatocellular carcinoma after TAE: possible mechanisms of immune mediation

Spontaneous regression of hepatocellular carcinoma confirmed by surgical specimen: report of two cases and review of the literature

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