Abstract

Several possible mechanisms for spontaneous regression of hepatocellular carcinoma (HCC) have been reported. Spontaneous complete regression of HCC is extremely rare. We herein report a case of spontaneous pathological complete regression of HCC following decrement of elevated serum alpha-fetoprotein (AFP). The serum AFP of a 74-year-old man who underwent hepatic resection for HCC twice increased up to 7,529 ng/mL and then spontaneously decreased to 404 ng/mL in 2 months. Computed tomography, magnetic resonance imaging, and angiography revealed a liver tumor in segment 7 without early enhancement. With a diagnosis of recurrent HCC, partial hepatic resection was performed. The resected specimens revealed no HCC macroscopically, and pathological examination revealed only a small area with cell dysplasia. The patient remains well with normal serum AFP and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels for 29 months after the third hepatic resection without recurrence of HCC. We describe a case of spontaneous pathological complete regression of HCC following decrement of elevated serum AFP. Further studies are needed to identify the mechanism(s) of spontaneous regression of HCC.

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