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A ruptured sarcomatoid hepatocellular carcinoma treated with combined immunotherapy

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Abstract

Sarcomatoid hepatocellular carcinoma (sHCC) is a rare phenotype of HCC with extremely poor prognosis and no established pharmacological treatment. Interventional therapies such as radiofrequency ablation (RFA) or transcatheter arterial embolization (TAE) have been shown to limit the development of sHCC through mechanisms involving hypoxia-induced epithelial–mesenchymal transition. This report describes an 83-year-old man who developed sHCC 2 years after RFA treatment for HCC and experienced sHCC rupture. Following TAE-induced hematostasis, he was administered lenvatinib for tumor control. Although his physical status had improved, due to loss of fever and attenuation of arterial enhancement in the tumor, for 1 month after lenvatinib administration, tumor re-growth was observed 2 months after lenvatinib treatment. His general condition was preserved, and he was treated with 10 courses of atezolizumab plus bevacizumab (Atez+Bev), resulting in tumor shrinkage that was maintained for 3–8 months after Atez+Bev. Findings in this patient showed that combined immunotherapy was effective for sHCC. Further investigation in additional patients is required to maximize prognosis in patients with sHCC.

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Acknowledgements

We thank English Service for Scientists for English language editing.

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Authors and Affiliations

  1. The Third Department of Internal Medicine, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0194, Japan

    Yuno Goto, Kazuto Tajiri, Aiko Murayama, Nozomu Muraishi, Yuka Hayashi & Ichiro Yasuda

  2. Toyama University Hospital, Toyama, 930-0194, Japan

    Shinichi Tanaka

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  1. Yuno Goto
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  2. Kazuto Tajiri
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  3. Shinichi Tanaka
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  4. Aiko Murayama
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  5. Nozomu Muraishi
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  6. Yuka Hayashi
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  7. Ichiro Yasuda
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Correspondence to Kazuto Tajiri.

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Goto, Y., Tajiri, K., Tanaka, S. et al. A ruptured sarcomatoid hepatocellular carcinoma treated with combined immunotherapy. Clin J Gastroenterol 16, 244–249 (2023). https://doi.org/10.1007/s12328-023-01758-1

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  • DOI: https://doi.org/10.1007/s12328-023-01758-1

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