A 66-year-old female patient was diagnosed with hepatocellular carcinoma accompanied by neuropathic pain induced by a metastatic tumor that compromised root and spinal canal. Although her pain was relieved following medical treatment, breakthrough pain occurring 1-2 times a day was still distressing. Neuropathic pain in her right lower limb caused discomfort and irritability and decreased her quality of life. We had limited options to adjust her prescription drug regime, due to the side effect of these drugs. Although acupuncture therapy was only performed at her home once a week, the efficacy was outstanding. The patient did not report any further instances of breakthrough pain, and she did not require additional bolus morphine. She could comfortably live in her familiar surroundings with her family and did not require any emergency room visits or admission into the hospital during the last month of her life. She had excellent quality of life in the terminal period of her life, and could even participate in a family function during this time. The present case report suggests that acupuncture may have a role in treating neuropathic pain induced by bone metastasis in patients with advanced cancer across clinical and in-home settings.
Acupuncture Therapy ; Aged ; Bone Neoplasms ; complications ; secondary ; Carcinoma, Hepatocellular ; pathology ; Female ; Home Care Services ; Humans ; Liver Neoplasms ; pathology ; Neoplasms ; pathology ; Neuralgia ; etiology ; therapy ; Quality of Life

Spontaneous regression of hepatocellular carcinoma (HCC) is extremely rare. We report a case of 67-year-old man having HBV-associated HCC with multiple lung metastases which regressed spontaneously. The patient had single liver mass and received surgical resection. The mass was confirmed as HCC histopathologically. Nine years after surgical resection, a 3.3 cm sized recurred HCC was detected on the resection margin in CT scan. Transarterial chemoembolization (TACE) was performed 3 times, and lung metastases developed thereafter. The patient received 2 more sessions of TACE, however, metastatic lung nodules were in progress very rapidly. We decided to stop TACE and followed the patient regularly without any anti-cancer treatment. Nine months after development of lung metastasis, the size and number of metastatic lung nodules decreased and were not detected anymore after 14 months. Serum alpha-fetoprotein levels also decreased to normal range and no viable tumor was noted in the liver. The patient is still alive 12 years after the first diagnosis of HCC and 16 months after lung metastasis developed.
Aged ; Carcinoma, Hepatocellular/*pathology/secondary/therapy ; Chemoembolization, Therapeutic ; Hepatitis B, Chronic/complications/diagnosis ; Humans ; Liver Neoplasms/complications/*pathology/therapy ; Lung Neoplasms/*diagnosis/radiography/secondary ; Male ; Neoplasm Regression, Spontaneous ; Neoplasm Staging ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis

No abstract available.
Carcinoma, Hepatocellular/*complications/*secondary/therapy ; Embolization, Therapeutic ; Fatal Outcome ; Hemothorax/diagnosis/*etiology/therapy ; Humans ; Liver Neoplasms/*complications/*pathology/therapy ; Lymph Nodes/*pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Paracentesis ; Rupture, Spontaneous ; Tomography, X-Ray Computed ; Treatment Outcome

Chronic hepatitis C infection is an important cause of cirrhosis and hepatocellular carcinoma (HCC). Antiviral therapy (AVT) for patients with cirrhosis due to hepatitis C may retard the progression of cirrhosis and prevent both the development of HCC as well as the recurrence of hepatitis C following liver transplantation. This review highlights the issues associated with AVT for patients with compensated and decompensated cirrhosis due to hepatitis C virus.
Antiviral Agents ; therapeutic use ; Carcinoma, Hepatocellular ; prevention & control ; virology ; Disease Progression ; Hepacivirus ; Hepatitis C, Chronic ; complications ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; virology ; Liver Neoplasms ; prevention & control ; virology ; Liver Transplantation ; Secondary Prevention

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.
Antiviral Agents/therapeutic use ; Bone Neoplasms/radiography/secondary ; Carcinoma, Hepatocellular/diagnosis/pathology/*therapy ; Catheter Ablation ; Chemoembolization, Therapeutic/*adverse effects ; Hepatitis B/complications/drug therapy ; Humans ; Liver Cirrhosis/etiology ; Liver Neoplasms/diagnosis/pathology/*therapy ; Male ; Middle Aged ; Positron-Emission Tomography ; Soft Tissue Neoplasms/secondary ; Spinal Cord Injuries/*etiology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinical characteristics of bone metastasis of malignant tumors.

METHODSThe clinical data and survival time of 355 patients with bone metastasis of malignant tumors were retrospectively analyzed.

RESULTSThe bone metastasis occurred more frequently in men (male:female = 1.45:1). The most common primary tumors were lung cancer in men and breast cancer in women. The thoracic vertebrae, ribs, lumbar vertebrae and pelvic were frequently involved metastatic sites and the multiple bone metastasis was common (83.4%). The main symptom was pain (75.2%). Local masses, disfunctions, pathologic fracture and paraplegia occurred in a few patients while many patients were asymptomatic (22.0%). The most frequent radiographic manifestation was the osteolytic bone destruction (82.2%). Integrated treatments were taken, including chemotherapy, hormonal therapy, biological therapy, radiotherapy, surgery, bisphosphonate analgetics, etc. The clinical benefit rate in pain relief was 98.5% and the effective rate was 72.2% in radiographic imaging. The median survival time was 13.9 months. Among them, it was 34.9 months in prostate cancer and 4.6 months in hepatocellular carcinoma. The survival time was longer in bone metastasis without other organ metastasis. There was no significant difference between the single and multiple bone metastases regarding the survival time.

CONCLUSIONIt is important to master the clinical features of bone metastasis of malignant tumors for early diagnosis and treatment, and to improve the quality of life and prolong the survival time.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; diagnosis ; secondary ; therapy ; Breast Neoplasms ; pathology ; Carcinoma, Hepatocellular ; pathology ; secondary ; Combined Modality Therapy ; Female ; Humans ; Liver Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain ; etiology ; Pain Management ; Prostatic Neoplasms ; pathology ; Quality of Life ; Retrospective Studies ; Survival Rate ; Young Adult