PMC8366058_01
Presentation of two downstaged patients with HCC. (A) Before administering the combination therapy, contrast-enhanced CT exhibited tumor thrombus in the main trunk of the portal vein with enhancement during the arterial phase (black arrow). (B) After 4.5 months of the combination therapy, contrast-enhanced CT exhibited shrunken tumor size and necrotic tumor tissues in the portal vein without enhancement (black arrow). (C) Pathological examination confirmed HCC with massive necrosis (x400); the necrotic region is shown in a white rectangle. (D) Pathological examination confirmed that the PVTT was completely necrotic (x400); the necrotic region is shown in a white rectangle. (E) Contrast-enhanced CT showed tumor thrombus in the left main trunk of the portal vein with enhancement during the portal venous phase (black arrow). (F) After 6.5 months of the combination therapy, contrast-enhanced CT showed shrunken tumor size and absence of PVTT (black arrow). CT, Computed tomography; HCC, hepatocellular carcinoma; PVTT, portal vein tumor thrombus.
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A 47-year-old female patient was admitted and diagnosed as having BCLC stage C HCC with PVTT (Figure 2A). After 4.5 months of therapy, the CT reexamination exhibited necrotic tumor tissues in the portal vein without enhancement (Figure 2B). A right hemihepatectomy was performed, and the subsequent pathological examination confirmed the diagnosis of HCC and complete necrosis of PVTT (Figures 2C, D). Similar alleviation was also shown in a 61-year-old male patient who experienced a shrunk tumor size and, more importantly, an absence of PVTT in the left main trunk (Figures 2E, F).