May 2015

• 64-year old obese female presented with fatigue and unexplained weight loss
• History of nonalcoholic fatty liver disease (NAFLD), then nonalcoholic steatohepatitis (NASH)
• Lab results: AFP= 1,500 IU/ml
• ECOG=1; Child-Pugh A
• CT revealed 1 large liver mass, right side of liver close to a major blood vessel
• No extrahepatic disease
• Liver-directed therapy with DEB-TACE was performed
• Patient reported abdominal pain following DEB-TACE and required analgesics; low-grade fever
• Patient had a complete response
• AFP= 200 IU/ml at follow up

February 2017

• Follow-up imaging showed progression and evidence of bone metastases
• Therapy was initiated with sorafenib at 400 mg BID
• Follow-up testing showed liver decompensation