Hepatocellularis carcinomás beteg sikeres májátültetése TACE- és sorafenibkezeléssel elért tumorméret-csökkentés után. Társszakmák sikeres együttműködése

András, Csilla and Árokszállási, Anita and Csiki, Emese and Matolay, Orsolya and Árkosy, Péter (2023) Hepatocellularis carcinomás beteg sikeres májátültetése TACE- és sorafenibkezeléssel elért tumorméret-csökkentés után. Társszakmák sikeres együttműködése. LEGE ARTIS MEDICINAE, 33 (4). pp. 183-187. ISSN 0866-4811 (nyomtatott); 2063-4161 (elektronikus)

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Abstract

We present an instructive case of a long surviving female patient with primary liver cancer. She received transfusion during appendectomy, and 9 years later HCV positivity was diagnosed. That time the antiviral treatment did not succeed and liver cirrhosis developed. 24 years after the presumed HCV infection, hepatocellular carcinoma was diagnosed as a solitary tumour of the liver. Following two cycles of transarterial chemoembolization (TACE), during the exploratory laparotomy the tumour proved to be non-resectable be­cause of the malign hepatic hilar infiltration. Considering this, the multidisciplinary oncoteam recommended sorafenib treatment. The patient received sorafenib for 2.5 years that she well tolerated, and the tumour became smaller. After this, another TACE treatment was performed and the patient became suitable for liver transplantation. By the applied bridging therapy, after two unsuccessful donor calls, the liver transplantation was successfully performed. Long survival was finally achieved by the liver transplantation that solved both the cirrhosis and HCC conditions. By the newer direct-acting antiviral drugs, the patient became permanently HCV negative, and she is currently under hepatological care only. This case is a best example for possible tumour reduction and liver transplantation in inoperable hepatocellular carcinoma (HCC). We emphasise the importance of interdisciplinary collaboration while caring for patients with HCC. It is essential to delegate the patients to facilities where the full range of potentially relevant treatments, as well as the follow-up and care of the underlying liver disease are available.

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