Spontaneous Complete Necrosis of Hepatocellular Carcinoma: Possible Immune System Hypothesis

Abstract

Spontaneous regression of hepatocellular carcinoma (HCC) is an extraordinarily unusual phenomenon. The mechanisms underlying this intriguing phenomenon remain unknown. We report a 72-year-old man with a liver mass. MR pictures demonstrate arterial hypervascularity with venous washout. We performed a fine-needle aspiration cytology of this nodule and it allowed us to find an HCC well differentiated. Postoperative histopathologic findings demonstrated a spontaneous complete necrosis of HCC. The necrotic tissue was filled with large debris from a neoplastic tissue, regardless of no viable tumor cells were seen among them. The patient is alive and well for 2 years after surgery. The underlying mechanism of this phenomenon is not clear. The histologic findings of our patient are including the tumor necrosis, the severe inflammatory infiltration with lymphocytes and the thick fibrous capsule. We speculate that some immune mechanism may be involved in regression of HCC.




J Curr Surg. 2014;4(1):26-28
doi: http://dx.doi.org/10.14740/jcs204w