치료반응이 좋은 증례 현저하게 좋은 치료반응을 보인 진행성 간세포암(TNM 4)

초록

A 52-year-old male patient with liver cirrhosis was admitted due to right upper quadrant abdominal pain for 2 months. Recently, he had been diagnosed hepatocellular carcinoma on abdominal sono and CT of local hospital. Physical findings revealed that he had mild tenderness on right upper quadrant without jaundice and hepatomegaly with 2 FB. Total bilirubin was 1.1 mg/dL, AST/ALT was 57/15 IU/L, and AFP was 235,000 ng/ml. Abdomen CT scan showed 13×12 cm sized mass involving chiefly right liver lobe with tumor thrombi involving right portal system and main portal trunk without arterioportal shunt. Small daughter nodule was seen in Lt. lobe, about 1.5 cm in diameter. CTAP showed perfusion defect involving chiefly right liver lobe with tumor thrombi and small daughter nodule in Lt. lobe. CTHA showed enhancing mass involving same site. Celiac angiogram showed hypervascular tumor involving right liver lobe and no evidence of remarkable arterial portal shunt, so he was treated with TACE. During 15 months, he received total 9th TACE with adriamycin for 6th TACE and cisplatin for 3th TACE. After 9th TACE, there were no remnant survived tumor and portal vein thrombosis. Primary lesion decreased to 5×4 cm sized mass with partial response and AFP returned to normal level from 235,000 ng/ml after treatment.

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