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

Abstract

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

Quantitative implementation of the endogenous molecular–cellular network hypothesis in hepatocellular carcinoma

“…Secondly, similar strategies have been successfully used in a subtype of APL to turn it from highly fatal to highly curable [24]; our predication suggests that these concepts should be used in solid tumours. Thirdly, clinical cases have independently reported the spontaneous regression of HCC [14]; however, spontaneous regression is a rare event. The predicated combined strategies here may make rare HCC spontaneous regression a more probable phenomenon.…”

“…carcinogenic factors caused cancer by their damage to normal genomes [3,4]. Nevertheless, there is extensive experimental and theoretical evidence to suggest that the genome is not the whole story [5][6][7][8][9][10][11][12][13][14]. Although cancers are often characterized by genetic alteration, it is certainly clear that genetic alterations are not always a prerequisite for the initial genesis of cancer.…”

“…Despite the fact that effective therapies are still lacking for most cancers [23], we are motivated to address the issues from both clinical and experimental perspectives. For example, we know that there have been independent reports of the spontaneous regression of cancer; despite it being a rare event [13,14], there is optimism that cancer may be cured or relieved. In fact, tumorigenesis is also a rare event, caused by factors such as oncogenes; however, they have been overexpressed or activated to increase the probability of tumorigenesis.…”

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

“…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.…”

“…[1][2][3][4] Although immunological mechanisms may play important roles in spontaneous regression, 1,2,4 to our knowledge, there have been no reports of detailed investigations of such phenomena. In this report, we describe a patient with spontane-T. Nakai (*) · T. Shimomura · F. Hirokawa First Department of Surgery, National Sengokusou Hospital, 1191 Nagose, Kaizuka, Osaka 597-0042, Japan Tel.…”