Rapidly growing hepatocellular carcinoma recurrence during direct-acting antiviral treatment for chronic hepatitis C
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We herein report the case of a woman in her 80s with a recurrent hepatocellular carcinoma (HCC) tumor that rapidly increased in size during direct-acting antiviral (DAA) treatment. She suffered from HCC at her initial visit to our department and underwent hepatectomy. Thereafter, she underwent DAA treatment for chronic hepatitis C; however, her alpha-fetoprotein (AFP) level rapidly increased, and a liver tumor of > 1 cm in diameter was observed that had not been seen immediately before DAA treatment. She underwent hepatectomy again and moderate to poorly differentiated HCC was diagnosed. The patient’s AFP level showed a rapid increase immediately after the start of DAA treatment; however, the increase ceased after the first month, and the influence from the surrounding environment of the tumor was considered to be temporary.
KeywordsDirect-acting antivirals Hepatitis C virus Hepatocellular carcinoma Rapid increase Treatment
We thank Assoc. Prof. Hidetaka Yamamoto of the Department of Anatomic Pathology, Pathological Science, Graduate School of Medical Sciences, Kyushu University (Fukuoka, Japan), for his pathological diagnosis, and Prof. Shinichi Aishima of the Departments of Pathology and Microbiology, Saga University Faculty of Medicine (Saga, Japan), for his advice.
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from this patient for being included in this case report.
- 1.World Health Organization. Global hepatitis report 2017. http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/. Accessed 2 Feb 2018.