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Hepatocellular Carcinoma Case Studies

Case Studies: Unresectable HCC with a History of Hepatitis C Virus

Ghassan K. Abou-Alfa, MD reviews the case and treatment of a patient with unresectable, metastatic hepatocellular carcinoma (HCC).

Unresectable HCC with a History of Hepatitis C Virus

A 60-Year-Old Male With Unresectable HCC and a History of HCV

  • Medical History and Physical Exam
    • A 60-year-old Asian man presented to his gastroenterologist with abdominal pain (upper-right quadrant).
    • History of diabetes, hypertension controlled with ramipril, chronic hepatitis C virus (HCV), diagnosed and treated 9 years ago with interferon
    • ECOG Performance Status 0
  • Work-up and Diagnosis
    • MRI abdomen: single 7-cm lesion on right hepatic lobe
    • Biopsy: confirmed hepatocellular carcinoma (HCC)
    • The tumor was deemed unresectable upon surgical evaluation.
  • Initial Therapy
    • Transarterial chemoembolization performed (x3); excellent response
  • Follow-up
    • Six months later: CT showed multifocal HCC in left abdominal wall, liver lesions, and lung metastases.
    • Child-Pugh score, A5
    • BCLC stage C (advanced stage)
    • Weight, 79 kg
    • Α-Fetoprotein level, 752 ng/mL
  • Treatment of metastatic disease and follow-up
    • The patient received lenvatinib 12 mg QD
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