J Liver Cancer.  2023 Mar;23(1):230-234. 10.17998/jlc.2023.03.03.

The development of hepatocellular carcinoma during long-term treatment for recurrent non-small cell lung cancer: a case report

• Na SK
• Kang SH

• KMID: 2540837
• DOI: http://doi.org/10.17998/jlc.2023.03.03

Abstract

Multiple primary malignancies (MPMs) are defined as the presence of two or more malignancies in different organs, without a subordinate relationship. Although rarely reported, hepatocellular carcinoma (HCC) occasionally presents with simultaneous or metachronous primary malignancies in other organs. In this report, we describe a patient with lung adenocarcinoma and lymph node and bone metastases, treated with five chemotherapeutic regimens for 24 months. Changing the chemotherapy regimen based on the suspicion of metastasis of a new liver mass did not lead to improvements. This prompted a liver biopsy and a revised diagnosis of HCC. Sixth-line treatment with the concurrent use of cisplatin-paclitaxel for lung cancer and sorafenib for HCC, stabilized the disease. The concurrent treatment was not tolerated and was discontinued owing to adverse events. Considering our findings, treatment with increased efficacy and lower toxicity for MPMs is warranted.

Keyword

Neoplasms, second primary; Carcinoma, hepatocellular; Lung neoplasms

Figure

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  Figure 1. Chest computed tomography (CT) and bone scan before and after chemotherapy for lung cancer. (A, C) Images on initial admission and (B, D) after second-line treatment with afatinib. The primary lesion (arrow) decreased and disappeared after chemoradiotherapy.

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  Figure 2. (A) Follow-up chest CT showed a 14 cm tumor in the right lobe of the liver. (B) At the time of HCC diagnosis, liver dynamic CT revealed a heterogeneous 18 cm HCC with hepatic vein invasion. CT, computed tomography; HCC, hepatocellular carcinoma.

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  Figure 3. Histopathological findings of the mass in the right hepatic lobe. (A) The biopsy specimens of the mass stained with hematoxylin and eosin demonstrate well-differentiated hepatocellular carcinoma. (B) On immunostaining, the tumor cells are weakly positive for membranous programmed death-ligand 1 expression (arrow).

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  Figure 4. Follow-up computed tomography after treatment (sorafenib for HCC and cisplatin-paclitaxel for lung cancer). (A) slightly increasedsized HCC and (B) similar-sized lung cancer (arrow). HCC, hepatocellular carcinoma.

Reference

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