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Pathologically Confirmed Spontaneous Partial Regression of Hepatocellular Carcinoma

병리조직학적으로 진단된 부분적 자발 퇴행 간암 환자 1예

  • Yoo, Jeong-Ju (Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine) ;
  • Lee, Jeong-Hoon (Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine) ;
  • Lee, Kyung Boon (Department of Pathology, Seoul National University College of Medicine) ;
  • Koh, Jae Moon (Department of Pathology, Seoul National University College of Medicine) ;
  • Lee, Minjong (Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine) ;
  • Choi, Young Hoon (Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine) ;
  • Yoon, Jung-Hwan (Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine)
  • 유정주 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 이정훈 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 이경분 (서울대학교 의과대학 병리학교실) ;
  • 고재문 (서울대학교 의과대학 병리학교실) ;
  • 이민종 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 최영훈 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 윤정환 (서울대학교 의과대학 내과학교실, 간연구소)
  • Received : 2013.06.07
  • Accepted : 2013.08.05
  • Published : 2014.02.01

Abstract

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.

54세 남자 환자가 건강 검진에서 간 내 종괴를 진단받았다. 영상학적 소견 및 만성 B형간염 병력을 고려하여 간암으로 임상적으로 진단되었으나 개인적인 이유로 치료를 연기하였고 5개월 후 다시 검사를 시행하였다. 역동적 복부 자기공명영상에서 60% 이상 부피가 감소하여 간우엽 절제술을 시행하였고 병리조직학적 검사에서 간암으로 확진되었다. 부분적 자발 퇴행 간암은 다른 간암에 비해 림프구, 특히 $CD4^+$ T 림프구 침윤이 많았으며 $CD4^+$ T 림프구가 자발성 퇴행에 미치는 영향은 추가적인 연구가 필요할 것으로 사료된다.

Keywords

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  1. Spontaneous Neoplastic Remission of Hepatocellular Carcinoma vol.65, pp.5, 2014, https://doi.org/10.4166/kjg.2015.65.5.312