Yamauchi Yurika, Saeki Issei, Yamasaki Takahiro, Egusa Maho, Nishiyama Natsuko, Fujioka Tsuyoshi, Kawamoto Daiki, Nishimura Tatsuro, Tanabe Norikazu, Oono Takashi, Matsumoto Toshihiko, Ishikawa Tsuyoshi, Marumoto Yoshio, Matsukuma Satoshi, Shindo Yoshitaro, Tokumitsu Yukio, Yoshimine Sota, Murakami Junichi, Tanaka Toshiki, Kimura Sotai, Hoshii Yoshinobu, Hamano Kimikazu, Nagano Hiroaki, Takami Taro
Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Department of Oncology and Laboratory, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Hepatol Res. 2023 Jul;53(7):681-686. doi: 10.1111/hepr.13894. Epub 2023 Mar 14.
Primary hepatic angiosarcoma (PHA) is extremely rare, and its imaging findings are similar to those of other liver tumors including hepatocellular carcinoma (HCC). Here, we report a case of hepatitis C virus (HCV)-related HCC followed by PHA that showed remarkable clinical response to atezolizumab plus bevacizumab (Atezo/Bev) therapy.
A 78-year-old man with recurrent HCC had a liver tumor with lymphadenopathy. Although considered as HCC recurrence, microscopic examination of the resected liver and lymph node showed PHA. Three months later, a solitary lung nodule was newly detected and subsequently resected. The pathological diagnosis was poorly differentiated HCC. Therefore, the patient was finally diagnosed with double cancer of PHA and HCC. Thereafter, he developed a new liver tumor with lymphadenopathy and received Atezo/Bev therapy. Liver tumor biopsy was carried out before the treatment. The pathological diagnosis was angiosarcoma. The patient showed a partial response after two courses of Atezo/Bev therapy.
To our best knowledge, this report is the first case to present HCV-related HCC followed by PHA and to show that Atezo/Bev therapy is beneficial for PHA.
原发性肝血管肉瘤（PHA）极为罕见，其影像学表现与包括肝细胞癌（HCC）在内的其他肝脏肿瘤相似。在此，我们报告一例丙型肝炎病毒（HCV）相关的HCC继发PHA的病例，该病例显示出对阿替利珠单抗联合贝伐单抗（阿替利珠单抗/贝伐单抗）治疗有显著临床反应。
一名78岁复发性HCC男性患者有肝脏肿瘤伴淋巴结病。尽管最初考虑为HCC复发，但对切除的肝脏和淋巴结进行显微镜检查显示为PHA。三个月后，新发现一个孤立性肺结节并随后切除。病理诊断为低分化HCC。因此，该患者最终被诊断为PHA和HCC双癌。此后，他出现了新的肝脏肿瘤伴淋巴结病，并接受了阿替利珠单抗/贝伐单抗治疗。治疗前进行了肝脏肿瘤活检。病理诊断为血管肉瘤。该患者在接受两个疗程的阿替利珠单抗/贝伐单抗治疗后出现部分缓解。
据我们所知，本报告是首例呈现HCV相关HCC继发PHA并表明阿替利珠单抗/贝伐单抗治疗对PHA有益的病例。
