Spontaneous regression of hepatocellular carcinoma: a case report

We report a hepatocellular carcinoma that appeared to undergo spontaneous regression twice. On June 5, 1995, two hepatocellular carcinomas were detected by ultrasonography in a 72-year-old woman. On July 1, 1995, the tumor in the lateral segment had increased in size from 2.0 cm to 3.2 cm in 27 days, and the level of alpha-fetoprotein (AFP) had increased from 743 to 1300 ng/ml. On September 22, 1995, one tumor appeared as a typical hypervascular lesion on contrast-enhanced computed tomography. It was 3.9 cm in size and located in the posterior segment. The other was a 3.9-cm cystic mass located in the lateral segment. The tumor in the posterior segment was treated with an emulsion of epirubicin and lipiodol administered via the posterior branch of the right hepatic artery and percutaneous ethanol injection. The tumor in the lateral segment was kept under observation because it was avascular, had regressed to 2.0 cm in size, and the patient's AFP level had decreased to 237 ng/ml by December 5, 1995. By February 21, 1996, the AFP level had increased again to 105,340 ng/ml, and by March 22, 1996, the latter tumor had increased in size to 3.8 cm. However, it later regressed again to 1.6 cm, and the AFP level decreased spontaneously to 7 ng/ml. From the changes in the contrast-enhanced computed tomographic images, and the level of AFP, we cannot rule out the possibility that the spontaneous regression might have been caused by the tumor's rapid growth.