Lee Jangwon, Lee Namhee, Yoon Hye Kyoung, Lee Yeon Jae, Park Sung Jae
Departments of Gastroenterology and Hepatology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Departments of Pathology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Korean J Gastroenterol. 2019 May 25;73(5):303-307. doi: 10.4166/kjg.2019.73.5.303.
Spontaneous regression of tumors is an extremely rare event in hepatocellular carcinoma (HCC) with only a few reports available. With the accumulation of clinical information and tumor immunogenetics, several mechanisms for the cystic changes of HCC have been suggested, including arterial thrombosis, inflammation, and rapid tumor growth. This paper reports an uncommon case of the partial regression of HCC, which was initially misdiagnosed as a mucinous cystic neoplasm of the liver due to the unusual radiologic findings. A 78-year-old female with the hepatitis B virus and liver cirrhosis presented with an approximately 5 cm-sized cystic mass of the liver. From the radiologic evidence of a papillary-like projection from the cyst wall toward the inner side, the initial impression was a mucinous cystic neoplasm of the liver. The patient underwent a surgical resection and finally, cystic degeneration of HCC, in which approximately 80% necrosis was noted. This case suggests that if a cystic neoplasm of liver appears in a patient with a high risk of HCC on a hepatobiliary imaging study, it is prudent to consider the cystic degeneration of HCC in a differential diagnosis.
肿瘤自发消退在肝细胞癌（HCC）中是极为罕见的事件，仅有少数报道。随着临床信息和肿瘤免疫遗传学的积累，已提出了几种HCC发生囊性变的机制，包括动脉血栓形成、炎症和肿瘤快速生长。本文报告了1例不常见的HCC部分消退病例，该病例最初因不寻常的影像学表现而被误诊为肝脏黏液性囊性肿瘤。1例患有乙型肝炎病毒和肝硬化的78岁女性，肝脏出现一个约5 cm大小的囊性肿块。根据从囊壁向内侧呈乳头状突出的影像学证据，最初诊断为肝脏黏液性囊性肿瘤。患者接受了手术切除，最终确诊为HCC囊性变，其中观察到约80%的坏死。该病例表明，如果在肝胆影像学检查中，肝脏囊性肿瘤出现在HCC高危患者中，在鉴别诊断时谨慎考虑HCC囊性变是明智的。
