PMC8855209_01
Abdominal computed tomography (CT) shows the tumor in the left lobe of the liver considered to be HCC with multiple metastases in the right lobe of the liver, and with tumor thrombosis in the left portal vein and lung metastases. (A) The huge tumor in the left lobe of the liver; (B) the multiple metastases in the right lobe of the liver; (C) the lung metastases; (D) the tumor thrombosis in the left portal vein.
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F1
The enhanced CT revealed small nodules in the middle and lower lobes of the lungs that were considered lung metastases, the tumor in the left lobe of the liver was considered HCC with multiple metastases in the right lobe of the liver, and tumor thrombosis was present in the left portal vein (Figure 1).
Magnetic resonance imaging (MRI) shows the tumor in the left lobe of the liver with multiple metastases in the liver, and with tumor thrombosis in the left portal vein. (A) The huge tumor in the left lobe of the liver; (B) the multiple metastases in the right lobe of the liver.
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F2
The magnetic resonance imaging (MRI) showed the tumor in the left lobe of the liver with multiple metastases in the right lobe of the liver, and with tumor thrombosis in the left portal vein (Figure 2).
Abdominal computed tomography (CT) shows that multiple small nodules in both lungs were significantly reduced and shrunken and the tumor in the liver was significantly reduced. (A) The lung metastases was reduced and shrunken; (B) the tumor in the left lobe of the liver shrunk; (C) the tumor thrombosis in the left portal vein.
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F3
And tumor thrombus had formed in the left and right branches of the portal vein (Figure 3).
Microscopic examination of the tumor revealed necrosis of the massive HCC with no tumor cells observed on the resection margins, and the portal vein tumor thrombus had necrotic tissue. (A) Necrosis of massive HCC; (B,C) the pathological examination.
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F4
The pathological diagnosis showed that the portal vein tumor thrombus had necrotic tissue (Figure 4).
Alpha fetoprotein (AFP) change trend and treatment options. (A) TAE + HAIC + sorafenib + camrelizumab; (B) dTACE + sorafenib + camrelizumab; (C) sorafenib-regorafenib + camrelizumab; (D) cTACE + regorafenib + camrelizumab; (E) radical surgical resection.
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F5
The AFP levels remained within the normal limits (Figure 5).