Two cases of spontaneous regression of multicentric hepatocellular carcinoma after intraperitoneal rupture: possible role of immune mechanisms.
We report two cases of spontaneous regression of hepatocellular carcinoma. Firstly, a 64-year-old man with alcohol related cirrhosis developed multiple liver tumours with elevation of the alpha-fetoprotein level at 915 ng/ml. A spontaneous regression of all the tumoural masses but one and normalization of the alpha-fetoprotein level was observed after intraperitoneal spread of the malignancy. Resection of the remaining tumour 9 months later confirmed a hepatocellular carcinoma. Secondly, a 70-year-old woman with alcohol related cirrhosis developed multiple liver tumours with elevation of the alpha-fetoprotein level to 4000 ng/ml; a regression of all the tumoural masses but one and a decrease of the alpha-fetoprotein level to 400 ng/ml was observed after intraperitoneal spread of the malignancy and treatment with tamoxifen. We discuss a possible immune mechanism of tumoural regression with a review of similar cases described in the literature.
Blondon
Hugues
H
Department of Hepato-gastroenterology, Centre Hospitalier, Montargis, France. hblondon@ch-montargis.fr
Fritsch
Laurence
L
Cherqui
Daniel
D
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous / Q000276:immunology* / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods