Pathologically Confirmed Spontaneous Partial Regression of Hepatocellular Carcinoma / 대한내과학회지

Spontaneous regression of hepatocellular carcinoma (HCC) is extremely rare, and dozens of cases have been reported in the literature. In this report, we present a case of pathologically confirmed HCC that partially regressed without medical intervention. A 54-year-old Korean male with chronic hepatitis B had a hepatic mass detected by abdominal ultrasonography during a routine visit. A clinical diagnosis of HCC was made after measuring serum alpha-fetoprotein levels followed by dynamic computed tomography and magnetic resonance imaging. The patient delayed surgical resection; however, after 5 months, the size of the HCC decreased from 3.2 to 1.0 cm in diameter without any treatment. At that time the mass was surgically resected. Histopathology confirmed that the hepatic mass was consistent with partially regressed HCC and showed more intra- and peri-tumoral lymphocytes consisting of greater CD4+ T cell infiltration than what is normally seen in resected HCC.

Pathologically Confirmed Spontaneous Partial Regression of Hepatocellular Carcinoma / 대한내과학회지

Spontaneous regression of hepatocellular carcinoma (HCC) is extremely rare, and dozens of cases have been reported in the literature. In this report, we present a case of pathologically confirmed HCC that partially regressed without medical intervention. A 54-year-old Korean male with chronic hepatitis B had a hepatic mass detected by abdominal ultrasonography during a routine visit. A clinical diagnosis of HCC was made after measuring serum alpha-fetoprotein levels followed by dynamic computed tomography and magnetic resonance imaging. The patient delayed surgical resection; however, after 5 months, the size of the HCC decreased from 3.2 to 1.0 cm in diameter without any treatment. At that time the mass was surgically resected. Histopathology confirmed that the hepatic mass was consistent with partially regressed HCC and showed more intra- and peri-tumoral lymphocytes consisting of greater CD4+ T cell infiltration than what is normally seen in resected HCC.

Staging of Hepatic Fibrosis: Comparison of Magnetic Resonance Elastography and Shear Wave Elastography in the Same Individuals

OBJECTIVE: To cross-validate liver stiffness (LS) measured on shear wave elastography (SWE) and on magnetic resonance elastography (MRE) in the same individuals. MATERIALS AND METHODS: We included 94 liver transplantation (LT) recipients and 114 liver donors who underwent either MRE or SWE before surgery or biopsy. We determined the technical success rates and the incidence of unreliable LS measurements (LSM) of SWE and MRE. Among the 69 patients who underwent both MRE and SWE, the median and coefficient of variation (CV) of the LSM from each examination were compared and correlated. Areas under the receiver operating characteristic curve in both examinations were calculated in order to exclude the presence of hepatic fibrosis (HF). RESULTS: The technical success rates of MRE and SWE were 96.4% and 92.2%, respectively (p = 0.17), and all of the technical failures occurred in LT recipients. SWE showed 13.1% unreliable LSM, whereas MRE showed no such case (p < 0.05). There was moderate correlation in the LSM in both examinations (r = 0.67). SWE showed a significantly larger median LSM and CV than MRE. Both examinations showed similar diagnostic performance for excluding HF (Az; 0.989, 1.000, respectively). CONCLUSION: MRE and SWE show moderate correlation in their LSMs, although SWE shows higher incidence of unreliable LSMs in cirrhotic liver.