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BIBTEX RIS

Downstaging and resection after neoadjuvant therapy for fibrolamellar hepatocellular carcinoma

2014; Baishideng Publishing Group; Volume: 6; Issue: 6 Linguagem: Inglês

10.4240/wjgs.v6.i6.107

1948-9366

Gilton Marques Fonseca, Antônio Drauzio Varella, Fabrício Ferreira Coelho, Emerson Shigueaki Abe, Rodrigo Blanco Dumarco, Paulo Herman,

Liver Disease Diagnosis and Treatment

Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare malignant liver neoplasm, commonly observed in adolescents and young adults of both genders.The disease is more common in Caucasians and in patients without a prior history of liver disease.The best treatment option is a surgical resection associated with liver hilum lymph node dissection.However, there is no established systemic drug treatment for patients with locally advanced or metastatic disease.We report on a patient with advanced FLHCC, initially considered unresectable due to invasion of the right and the middle hepatic veins and circumferential involvement of the left hepatic vein.Following the treatment with gemcitabine-oxaliplatin systemic chemotherapy, the patient exhibited a significant tumor reduction.As a result, a complete resection was performed with an extended right hepatectomy associated with a partial resection of the inferior vena cava, a wedge resection in segment 2, and lymphadenectomy of the hepatic hilum.The case was unusual due to the significant tumor downstaging with gemcitabine-oxaliplatin, potentially enabling curative resection.More studies are needed to confirm the efficacy of the systemic drug treatment for FLHCC.