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Macrotrabecular-Massive Hepatocellular Carcinoma: A Case Report.

Raphaël Eftimie Spitz¹, Simona Manole², Teodora Surdea-Blaga³

¹Department of Clinical Immunology and Allergology, Iuliu Hatieganu University of Medicine and Pharmacy of Cluj, Cluj-Napoca, ROU.

|January 21, 2025

Summary

Macrotrabecular-massive hepatocellular carcinoma (MTM-HCC), an aggressive liver cancer subtype, presents unique challenges due to its occurrence in non-cirrhotic livers and poor response to standard treatments. This case highlights the urgent need for novel therapeutic strategies for MTM-HCC.

Keywords:

abdominal ct scans artificial intelligence case report chest ct scan hbv infection hepatocarcinoma immunotherapy macrotrabecular-massive hepatocellular carcinoma mri pet-ct scan

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Area of Science:

Hepatology
Oncology
Molecular Pathology

Background:

Macrotrabecular-massive hepatocellular carcinoma (MTM-HCC) is a rare, aggressive subtype of liver cancer.
Unlike typical HCC, MTM-HCC can occur in non-cirrhotic livers, posing diagnostic and therapeutic challenges.

Observation:

A 35-year-old male presented with epigastric pain, fatigue, and hepatomegaly.
Imaging revealed a large hepatic mass with portal vein thrombosis and metastases.
Histopathology confirmed MTM-HCC.

Findings:

The patient received standard treatment for advanced HCC (immune checkpoint inhibitors and anti-angiogenic agents).
Disease progression occurred after four cycles, leading to a rapid decline and death.
MTM-HCC exhibits distinct molecular and histological features contributing to its aggressive nature and poor prognosis.

Implications:

This case underscores the aggressive behavior and limited treatment responsiveness of MTM-HCC.
Heightened clinical vigilance is crucial for early detection, especially in younger patients with atypical liver disease symptoms.
Developing targeted therapies and further research into MTM-HCC molecular characteristics are essential for improving patient outcomes.