Spontaneous Regression of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is a malignant tumor frequently occurring in Koreans. It is well known that the prognosis of HCC is extremely poor. Most patients die within 3-6 months after diagnosis from gastrointest-inal hemorrhage, progress ive cachexia or liver failure 1). S pontaneous regression of HCC is a rare phenomenon and has, to our knowledge, been described in very few patients 2-8). The underlying mechanism of this regress ion is unclear. We report here a case of fine needle aspiration biopsy (FNAB)-proved HCC, with spontaneous regression demonstrated by imaging study. A 54-year-old female was admitted because of burning pain in her right upper abdomen for 5 days, which tended to increase when she coughed or took a deep breath. Her past medical history had relevance to liver cirrhos is associated with hepatitis B virus. There was no known history of excessive alcohol intake, blood transfusion, exposure to hepatotoxic chemicals , family history of liver disease or oral contraceptive intake. She did not smoke. On phys ical examination, the right upper abdomen was tender and irregular hep-atomegaly was noted 4 cm below the costal margin. Laboratory studies disclosed leukocytes 7x10 3 /¥ìL, hemoglobin 8.9 g/dL, Hct 25.1%, platelet 123x10 3 /¥ìL, total bilirubin 0.5 mg/dL, serum aspartate transaminase (AST) 55 IU/L, serum alanine transaminase (ALT) 44 IU/L, ¥á-fetoprotein (¥áFP) 3-4 ng/mL, CA19-9 17 U/mL and CEA 6.1 ng/mL. Hepatitis B s urface antigen was positive. Both abdominal ultrasonography and computed tomogra phy s howed a we ll-circumscribed s pace-occupying lesion in the right lobe, measuring 7 cm in the largest diameter (Figure 1). Computed tomography-guided FNAB was performed at the mass. Papanicolaou's smears revealed high cellularity (Figure 2). Many clusters of polygonal cells s howed long, thick anastomosing cords covered by S p o nt a n e o u s Re g r e s s io n of He p a t o c e llu la r Ca r c in o m a-A C a s e Re p o rt-T a e J u n g J a n g , M. S p o nt a n e o u s re g re s s io n o f c a n c e r is a ra re p h e n o m e n o n s e ld o m d e s c rib e d in p a …