title: Spontaneous regression of diffuse intrahepatic recurrence with portal vein tumor thrombus after resection of hepatocellular carcinoma.
abstract: We report a rare case of spontaneous regression of diffuse intrahepatic recurrence with portal vein tumor thrombus (PVTT) after resection of hepatocellular carcinoma (HCC). A 68-year-old man with hepatitis C virus-related liver cirrhosis presented with a 40 mm tumor in the right anterior segment of the liver. The tumor was diagnosed as HCC by typical imaging findings and elevated serum alpha-fetoprotein (AFP) (716 ng/ml) and protein induced by vitamin K absence II (PIVKA II) (8,100 ng/ml). A right anterior sectionectomy of the liver was performed. Microscopically, the tumor was moderately differentiated HCC. Four months after resection, a computed tomography (CT) scan showed diffuse intrahepatic recurrence with PVTT. Serum AFP was 12,319 ng/ml and PIVKA II was 168,000 ng/ml. The patient did not receive any further treatment for HCC including herbal medicine, and stopped smoking. Two years and 5 months later, no lesion was detected on a CT scan when serum AFP was 1.9 ng/ml. Ischemia due to main portal vein occlusion and rapid tumor growth might have induced tumor regression in the present case. Moreover, abstention from smoking might have improved his immunological function.
authors.affiliation: Department of Gastroenterology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan. aokano@tenriyorozu-hp.or.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Okano
authors.affiliation: Department of Gastroenterology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takakuwa
authors.affiliation: Department of Gastroenterology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Nakamura
keywords: Diffuse recurrence; Hepatocellular carcinoma; Portal vein tumor thrombus; Spontaneous regression