Two cases of spontaneous regression of multicentric hepatocellular carcinoma after intraperitoneal rupture: possible role of immune mechanisms

• Published in: European journal of gastroenterology & hepatology Vol. 16; no. 12; p. 1355
• Main Authors: Blondon, Hugues, Fritsch, Laurence, Cherqui, Daniel
• Format: Journal Article
• Language: English
• Published: England 01.12.2004
• Subjects: Aged; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - immunology; Carcinoma, Hepatocellular - pathology; Female; Humans; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - immunology; Liver Neoplasms - pathology; Male; Middle Aged; Neoplasm Regression, Spontaneous - immunology; Neoplasm Regression, Spontaneous - pathology; Neoplasms, Multiple Primary - diagnostic imaging; Neoplasms, Multiple Primary - immunology; Neoplasms, Multiple Primary - pathology; Peritoneal Diseases - diagnostic imaging; Peritoneal Diseases - pathology; Rupture, Spontaneous - diagnostic imaging; Rupture, Spontaneous - pathology; Tomography, X-Ray Computed - methods
• ISSN: 0954-691X
• DOI: 10.1097/00042737-200412000-00020

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.