The liver is one of the most common sites of metastasis. Although most metastatic liver cancers are hypovascular, some hypervascular metastases, such as those from melanoma, need to be differentiated from hepatocellular carcinoma (HCC) because they may show similar radiologic findings due to their hypervascularity. We encountered a case of multinodular liver masses with hyperenhancement during the arterial phase and washout during the portal venous and delayed phases, which were consistent with imaging hallmarks of HCC. The patient had a history of malignant melanoma and had undergone curative resection 11 years earlier. We performed a liver biopsy for pathologic confirmation, which revealed a metastatic melanoma of the liver. Metastatic liver cancer should be considered if a patient without chronic liver disease has a history of other primary malignancies, and caution should be exercised with hypervascular cancers that may mimic HCC.
Citations
Citations to this article as recorded by
A case of metastatic melanoma in the liver mimicking colorectal cancer with synchronous liver metastasis E.A. Warshowsky, M. McCarthy, K. Wells, A. Arcidiacono, L. Csury, J.R. Nitzkorski International Journal of Surgery Case Reports.2024; 119: 109686. CrossRef
The importance of ultrasound-guided biopsy: lesson from a case of liver metastasis from uveal melanoma Maria Boe, Susanna Vicari, Andrea Boccatonda, Fabio Piscaglia Journal of Ultrasound.2024; 27(4): 927. CrossRef
Backgrounds/Aims Hepatic arterial infusion chemotherapy (HAIC) has been reported as an effective treatment for advanced hepatocellular carcinoma. The aim of this study is to compare the effect and safety between a high-dose regimen (750 mg/m2 5-fluorouracil [FU] and 25 mg/m2 cisplatin on day 1-4) and a low-dose regimen (500 mg/m2 5-FU on day 1-3 with 60 mg/m2 cisplatin on day 2).
Methods A total of 48 patients undergoing HAIC were retrospectively analyzed. Thirty-two patients were treated with the high-dose and 16 patients with the low-dose regimen.
Results Complete response (CR), partial response (PR), stable disease (SD), and progressive disease were noted in one (3.1%), 15 (46.9%), three (9.4%), and 13 patients (40.6%) in the highdose group, and 0 (0%), one (6.3%), eight (50%), and seven patients (43.8%) in the low-dose group (p=0.002). The disease control rate (CR, PR, and SD) did not differ between groups (59.4% vs. 56.3%, p=1.000), but the objective response rate (CR and PR) was significantly higher in the high-dose group (50.0% vs. 6.3%, p=0.003). The median progression free survival did not differ between groups (4.0 vs. 6.0, p=0.734), but overall survival was significantly longer in the high-dose group (not reached vs. 16.0, p=0.028). Fourteen (43.8%) patients in the highdose group and two patients (12.5%) in the low-dose group experienced grade 3-4 toxicities (p=0.050).
Conclusions High dose HAIC may achieve better tumor response and may improve overall survival compared to a low-dose regimen. However, the high-dose regimen should be administered cautiously because of the higher incidence of adverse events.
Citations
Citations to this article as recorded by
A programmed cell death-related gene signature to predict prognosis and therapeutic responses in liver hepatocellular carcinoma Xinyu Gu, Jie Pan, Yanle Li, Liushun Feng Discover Oncology.2024;[Epub] CrossRef
Development of a novel chromatographic method for concurrent determination of 5-fluorouracil and cisplatin: Validation, greenness evaluation, and application on drug-eluting film Souha H. Youssef, Franklin Afinjuomo, Yunmei Song, Sanjay Garg Microchemical Journal.2021; 168: 106510. CrossRef
Current guidelines recommend sorafenib as the first-line molecular target agent for advanced
hepatocellular carcinoma (HCC) with extrahepatic metastasis and unresectable HCC. Sorafenib
was reported to show survival benefit for patients with advanced HCC. However, complete
response is extremely rare in patients treated with sorafenib. Here, we report a 52-year-old
man with advanced HCC and pulmonary metastasis who showed complete response by
sequential transarterial chemoembolization and continuous sorafenib. Complete response
was sustained for 53-month until now.
Brain metastasis is a rare condition of extraheptaic metastases in hepatocellular carcinoma
(HCC). Patients with hepatocellular carcinoma and brain metastasis have rapidly worsened
neurologic signs and symptoms, therefore it is regarded to oncologic emergency. Current
recommended treatments for brain metastasis are surgical resection or gamma-knife surgery
with/without whole brain radiation therapy (RT). However, patients with brain metastasis
have a very poor prognosis after adequate treatment. Here, we report a 62-year-old man with
HCC and brain metastasis who had long term survival after surgical resection and whole brain
RT. (J Liver Cancer 2016;16:38-41)