Successful Multidisciplinary Treatment with Laparoscopic Surgery and Sequential Multikinase Inhibitor Therapy for Multivisceral Recurrence of Hepatocellular Carcinoma

Background: Hepatocellular carcinoma with massive portal vein tumor thrombosis and distant metastasis is considered unresectable. However, due to recent developments in systemic chemotherapy, successful cases of conversion therapy for unresectable diseases have been reported. Herein, we report a multidisciplinary treatment sequential multikinase inhibitor laparoscopic surgery multivisceral recurrence. Case presentation: A 63-year-old woman chronic hepatitis B virus infection was diagnosed liver tumor. Subsequently, she underwent two rounds partial hepatectomy, left adrenalectomy, transcatheter arterial chemoembolization sorafenib Four years after the initial found 43 mm mass spleen thrombus that involved right anterior branches down main trunk severe ascites. Her function Child-Pugh (8), PIVKA II levels were elevated up 46,291 mAU/mL. The patient initially treated regorafenib but experienced disease progression 3 months later maximum value 129,815 then administered lenvatinib. Eighteen treatment, there no contrast enhancement splenic metastasis. This chemotherapy discontinued because grade diarrhea. Afterward, increased again rise II. Therefore, hand-assisted splenectomy performed. discharged 10 days postoperatively. There clinical evidence recurrence 14 resection. Conclusion: Conversion an effective option advanced HCC.