The optimal treatment strategy for unresectable huge hepatocellular carcinoma (HCC) is yet to be established. Non-surgical monotherapy demonstrated insufficient oncologic outcomes in previously reported studies. To improve the clinical outcomes of unresectable huge HCC, combined locoregional treatments can be considered in selected cases. Here, we report a case of 58-year-old male patient who was treated with combined transarterial chemoembolization (TACE) and external beam radiotherapy for recurrent HCC after a previous hepatic resection. After combined TACE and radiotherapy for the intrahepatic lesion, two metastases were diagnosed in the pelvic bones and lung; each lesion was successfully treated with salvage radiotherapy. During the long-term follow-up period (around 8 years 7 months after combined TACE and radiotherapy for the recurrent huge HCC), no definite viable tumors were observed in any of the treated liver, bone, and lung lesions.
Hepatocellular carcinoma (HCC) is the most common form of liver malignancy. Spontaneous
regression of HCC is extremely rare phenomenon and mechanism of regression remains obscure.
75-year-old woman previously diagnosed with hepatitis C virus-related liver cirrhosis
was found to have single mass in liver with elevation of α-fetoprotein level to 10,320 ng/mL.
Transarterial chemoembolization (TACE) was performed. 27 months after TACE recurred HCC
with multiple lung nodules were confirmed. The patient refused any therapeutic modality.
The patient underwent follow-up without any anti-cancer treatment. 8 months after recurrence
follow up computed tomography scan revealed spontaneous regression of HCC and
completely disappeared lung nodules. The patient is currently doing well and without any
evidence of recurrence. The causes of spontaneous regression of HCC are not well understood.
Proposed mechanisms are ischemic injury, biological factors, herbal medicine, immunological
variations. Further studies are necessary to improve our understanding of this rare phenomenon.