Hepatocellular carcinoma with renal invasion and its multimodal management: a rare case report

This case report presents a 60-year-old female diagnosed with hepatocellular carcinoma (HCC) and direct renal invasion. Imaging identified a large hepatic mass involving the right kidney, which was confirmed histopathologically and supported by elevated alpha-fetoprotein (AFP) levels. Treatment involved a multimodal strategy combining transarterial chemoembolization (TACE), fractionated radiotherapy, and combination immunotherapy with camrelizumab plus apatinib. Follow-up imaging and AFP trends showed marked tumor regression and biochemical improvement. This case highlights the rare entity of direct renal invasion from HCC and provides practical insights into its diagnosis and comprehensive management. It illustrates the clinical feasibility and potential benefit of a combined locoregional and systemic strategy in advanced HCC with such uncommon extrahepatic renal involvement, underscoring the importance of individualized treatment in these complex presentations.