Spontaneous complete regression of hepatocellular carcinoma with histopathological confirmation

Spontaneous regression (SR) of hepatocellular carcinoma (HCC) is an exceptional phenomenon, with an estimated incidence of 0.4% (1,2). Although various mechanisms have been proposed, including tumor ischemia and immune activation, its pathogenesis remains uncertain. Most published cases lack histological confirmation of tumor disappearance and have insufficiently documented follow-up. We present a case of SR with histopathological confirmation of complete tumor necrosis following exploratory laparoscopy, suggesting a possible ischemic mechanism and highlighting the challenges in therapeutic decision-making and in assessing the indication for liver transplantation.