Díaz López Sebastián, Jimeno Maté Carlota, Fernández Parra Eva María, Sánchez Vegas Adrián
Hepatic Oncology , Hospital Nuestra Señora de Valme, Spain.
Gastroenterology, Hospital Nuestra Señora de Valme.
Rev Esp Enferm Dig. 2024 Dec 4. doi: 10.17235/reed.2024.10942/2024.
A 62-year-old male with hepatocellular carcinoma on a healthy liver underwent surgery in April 2022. Five months after, the patient complained of abdominal pain, with an alpha-fetoprotein (AFP) level exceeding 9000 ng/ml, and CT images showed liver metastases and multiple lung metastases, so treatment with immunotherapy atezolizumab plus bevacizumab was started in September 2022. After four cycles, hyperprogression was observed in liver and lung metastases at first CT evaluation. However, abdominal pain improved, and AFP decrease, raising suspicion of pseudoprogression. Treatment was therefore continued until radiological progression could be confirmed with a follow-up CT scan after 2 months, which revealed a complete response of the pulmonary metastasis and a partial response of the liver metastasis.
一名62岁患有肝细胞癌且肝脏健康的男性于2022年4月接受了手术。五个月后，患者主诉腹痛，甲胎蛋白（AFP）水平超过9000 ng/ml，CT图像显示肝转移和多发肺转移，因此于2022年9月开始使用免疫疗法阿替利珠单抗联合贝伐单抗进行治疗。四个周期后，首次CT评估显示肝肺转移出现超进展。然而，腹痛有所改善，AFP下降，引发了假性进展的怀疑。因此继续治疗，直到2个月后通过后续CT扫描确认出现影像学进展，结果显示肺转移完全缓解，肝转移部分缓解。
