J Korean Soc Radiol.  2014 Oct;71(4):182-185. 10.3348/jksr.2014.71.4.182.

A Case of Spontaneous Regression of Hepatocellular Carcinoma after Ultrasound Guided Liver Biopsy

• Jo JH

• KMID: 2098003
• DOI: http://doi.org/10.3348/jksr.2014.71.4.182

Abstract

Spontaneous regression of hepatocellular carcinoma after liver biopsy has not been reported in the English literature. Herein, we present a case of partial spontaneous regression of hepatocellular carcinoma after ultrasound guided liver biopsy in a 64-year-old female. During 28 months, the tumor, which had been shrinking, showed no interval change. However, after 28 months, tumor showed regrowth, which led to a segmentectomy.

MeSH Terms

Biopsy*
Carcinoma, Hepatocellular*
Female
Humans
Liver*
Mastectomy, Segmental
Middle Aged
Ultrasonography*

Figure

• 

  Fig. 1 Spontaneous regression of hepatocellular carcinoma after ultrasound-guided liver biopsy in 64-year-old female. A-C. Initial abdomen CT images show a 7.5 × 4.7 cm sized ill-defined heterogeneous enhancing mass (arrows) in S5/8 of the liver in arterial phase (A) and washout of the contrast medium (arrow) in delayed phase (B). Initial abdomen ultrasound (US) image shows a heterogeneous echogenic mass (arrow) with a halo in S5/8 (C). D. Follow-up abdomen MR imaging after liver biopsy reveals a S8 mass (arrow) with contrast washout in delayed phase which is reduced in size to 3.3 × 3.5 cm. E, F. After 4 months, follow-up abdomen CT image shows a 2.4 × 1.8 cm sized mass (arrow) in S8 with contrast washout in delayed phase (E). Also, abdomen US image shows a size decrease of heterogeneous echogenic mass in S8 (F). G. After 28 month, S8 mass (arrow) shows increased size to 3.7 × 2.3 cm with contrast washout in delayed phase of abdomen CT. H-K. Gross specimen of segmentectomized liver shows multinodular confluent mass with massive necrosis, focal hemorrhage, fibrotic tissue with thick walled biliary trees, and viable yellowish pink fleshy tumor tissue (H). Microscopically, the tumor is associated with massive necrosis, extensive chronic inflammation with fibrosis (I; hematoxylin & eosin stain, × 4). Well-defined moderately differentiated hepatocellular carcinoma is present, and the boundaries of necrosis are occupied with variable numbers of poorly differentiated hepatocellular carcinoma cells (J; hematoxylin & eosin stain, × 200), of which some are stained with anti-CK19 (K; immunohistochemistry, × 200).

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