Downstaging case of hepatocellular carcinoma
“Written informed consent was obtained from the patient to publish this
report in accordance with the journal’s patient consent policy”
ABSTRACT
Introduction: Transarterial chemoembolization (TACE) is the most used
treatment option for patients with intermediate-stage hepatocellular
carcinoma (HCC) who are not candidates for a curative approach. Through
it, it is possible both to carry out palliative treatment and to reduce
the size of the tumor so that the patient is eligible for a curative
treatment such as a liver transplant. This modality of offering TACE to
reduce the tumor stage and allow curative treatment is called
“Downstaging”. Patients with HCC greater than 7 cm generally do not
respond very well to chemoembolization to reduce tumor size, and
generally this “downstaging” is not performed.
Objective: To disseminate information in the medical community about a
case of a patient with a hepatocellular carcinoma larger than 7 cm, who
underwent chemoembolization to reduce staging and who met eligibility
criteria for liver transplantation.
Methods: Data were collected from notes in the medical records, after
signing the informed consent form by the patient and approval by the
Research Ethics Committee.
Results: This study presents a case report of a 55-year-old man with
chronic liver disease and a history of infection by the hepatitis C
virus and the human immunodeficiency virus, who evolved with
non-invasive hepatocellular carcinoma in segment VI/VII of the liver out
of Milan criteria for curative therapeutic proposal. The patient
underwent two sessions of TACE, which were effective in reducing the
size of the tumor, making him eligible for curative treatment – liver
transplantation.
Conclusion: The case in question stands out for being a condition of
atypical evolution, where often, due to the size of the tumor, the
response to chemoembolization is not so significant. The case report is
justified in order to provide information and enable downstaging
attempts to be made in patients with similar profiles.
Keywords: Hepatocellular carcinoma. Transarterial
chemoembolization. TACE. Hepatitis C