Plain English summary of “Radiotherapy for Metastatic Fibrolamellar Hepatocellular Carcinoma“

Published in Rare Tumors, July 2013

This is a case report of a 28-year-old Caucasian female who was found to have Fibrolamellar HCC in the left lobe of the liver on a CT scan. The patient’s chest images did not reveal any metastases.  The patient underwent surgical resection in which doctors removed the primary tumor with negative margins. Three out of 6 lymph nodes were found to be positive for cancer. Three months after surgery, imaging was negative for metastases and alpha-fetoprotein levels (AFP) normalized. The patient was later found to have recurrences and had surgery again.  Twenty-two months post surgery, the patient developed new masses in the chest and was treated with radiation and chemotherapy. While the patient was on radiation therapy, the patient’s tumor decreased in size. After radiation therapy was completed, however, the lesions continued to progress on chemotherapy.

Plain English summary of Surgical resection of ruptured fibrolamellar hepatocellular carcinoma

Minutolo V, Licciardello A, Arena M, Minutolo O, Lanteri R, Arena G, Cae Reports in Surgery, 2013: PMID: 23956918

This is a case report of one male patient, 29 years old, who presented in the ER with sudden pain in the right upper abdomen, and was found to have a ruptured FL-HCC. His past medical history was completely unremarkable. The tumor, which measured 8 by 5 cm, ruptured, causing blood to spill into the abdomen, which in turn, caused intense pain by irritating the lining of the abdomen (“peritoneum”). The patient underwent emergency surgery to clear the hemoperitoneum (term for blood in the peritoneum) and to resect the tumor. He recovered but, six months after surgery, had recurrence of the tumor in both the liver and within the abdomen. He died 26 months after surgery. Tumor size greater than 5 cm has been associated with spontaneous rupture as in this case. Tumor rupture, and thus spillage of tumor into the abdomen, may very well have played a role in the patient’s recurrence and subsequent, death.