A case of spontaneous complete necrosis of hepatocellular carcinoma

We report a rare case of spontaneous complete necrosis of hepatocellular carcinoma. A 72-year-old man underwent distal gastrectomy due to perforation of gastric ulcer 50 years ago, and then was transfused. He had visited a hospital near his home to be treated for chronic hepatitis C and diabetes. Because we suspected him to be in the recovery stage of acute renal failure of unknown cause, he was admitted to our hospital. CT showed a mass of 2.5 cm in segment 8 of the liver. After that, we observed him for 8 months. The liver mass evidenced no remarkable change in size. Liver angiography showed ring enhancement consistent with the mass. AFP level was high at 972 ng/ml and PIVKA II level was also high at 1880 mAU/ml. We considered him to have hepatocellular carcinoma, and performed a partial resection of the liver. The resected specimen showed a tan necrotic mass with capsular formation. Histological findings showed complete necrosis of the cells in the mass, and no viable tumor cells were found. Postoperative tumor markers, AFP and PIVKA II, decreased to the normal range, so we considered it to be a case of spontaneous complete necrosis of hepatocellular carcinoma.