Massive Hepatocellular Carcinoma with Situs Inversus Totalis Achieved a Complete Response Following Camrelizumab Plus Apatinib and Combined with Two-Stage Hepatectomy: A Case Report

• Published in: Pharmacogenomics and personalized medicine Vol. 16; pp. 111 - 120
• Main Authors: Wu, Yining, Ou, Shenjian, Liao, Xiwen, Han, Chuangye, Yang, Chengkun, Qin, Wei, Tan, Yufeng, Lao, Quan, Peng, Tao, Ye, Xinping
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2023; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Abdomen; Antibodies; Biomarkers; Cancer therapies; Care and treatment; Case Report; Case reports; Conversion therapy; Development and progression; Diagnosis; future residual liver; Hepatectomy; Hepatitis B; Hepatitis C; Hepatocellular carcinoma; Hepatoma; Hospitals; Hyperplasia; Hypertrophy; Inhibitor drugs; Inversion; Laparoscopy; Liver; Liver cancer; Liver diseases; Magnetic resonance imaging; Medical prognosis; Monoclonal antibodies; multidisciplinary group discussion; Patients; Portal vein; situs inversus totalis; Surgery; Targeted cancer therapy; Thorax; Tomography; Tumors; two-stage hepatectomy; Ultrasonic imaging; Veins & arteries; China; future residual liver; multidisciplinary group discussion; situs inversus totalis; hepatocellular carcinoma; two-stage hepatectomy
• ISSN: 1178-7066; 1178-7066
• DOI: 10.2147/PGPM.S376596

Situs inversus totalis (SIT) is a rare congenital condition in which abdominal and thoracic organs are transposed from normal positions. Two-stage hepatectomy (TSH) combined with translational therapy for hepatocellular carcinoma (HCC) with SIT has been rarely reported. We report a 41-year-old man with giant hepatocellular carcinoma (71 mm × 55 mm × 51 mm) whose future residual liver (FLR) and standard liver volume (SLV) ratio at first diagnosis was 37.4%. Preoperative volume assessment of portal vein ligation (PVL) revealed inadequate hypertrophy of FLR. After a multidisciplinary group discussion (MDT), the patient decided to follow conversion therapy. Three months later, ratio of the FLR/SLV increased from 37.4% to 71% after operation, which met the surgical requirements. Second hepatectomy, right lobectomy was successful. There was no recurrence after six months of follow-up. In our case, conversion therapy appears to be effective in maintaining residual liver hyperplasia, reducing tumor load, and preventing tumor progression in patients with large HCC during TSH.