Curative lung metastectomy and complete pathological response after neo-adjuvant GEMOX chemotherapy for relapse fibrolamellar hepatocellular carcinoma

Med J Malaysia. 2018 Feb;73(1):46-48.

Abstract

Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of hepatocellular carcinoma. It is commonly reported in the younger population with no underlying chronic liver disease and free of viral Hepatitis B and C. Local recurrence and distant metastasis are common despite better prognosis compared to conventional hepatocellular carcinoma. Complete surgical resection is associated with higher median survival and is the mainstay treatment option for localized FL-HCC. Multi-modality therapies such as TACE can be used to downstage upfront unresectable FL-HCC. Complete response with GEMOX chemotherapy has been reported in advanced metastatic FL-HCC and should be considered in upfront unresectable or metastatic disease. We present a case of biopsied proven relapse FL-HCC with oligo- left lung metastasis who successfully underwent a left lung lobectomy after neo-adjuvant GEMOX chemotherapy, and is disease free at 24 months follow up.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Combined Modality Therapy
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Female
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung / surgery
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / therapy
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Organoplatinum Compounds / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Organoplatinum Compounds
  • Deoxycytidine

Supplementary concepts

  • Fibrolamellar hepatocellular carcinoma
  • gemcitabine-oxaliplatin regimen