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