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Case report
Spontaneous regression of hepatocellular carcinoma: myth or reality?
  1. Maria Pia Costa-Santos1,
  2. Afonso Gonçalves2,
  3. Alexandre Oliveira Ferreira1 and
  4. Joana Nunes1
  1. 1Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
  2. 2Radiology Department, Hospital Beatriz Ângelo, Loures, Portugal
  1. Correspondence to Dr Alexandre Oliveira Ferreira; alex.gastrohep{at}


We present a case of a 68-year-old man with chronic hepatitis C infection, with no evidence of chronic liver disease during the first years of follow-up, diagnosed with a hepatocellular carcinoma (HCC) with 40 mm (α-fetoprotein (AFP) 205 ng/mL). He underwent segmental liver resection and pathology analysis was consistent with HCC and cirrhosis in the adjacent liver. Four months after surgery, AFP raised up to 126 661 ng/mL and abdominal MRI revealed a multinodular HCC. Patient rejected treatment with sorafenib and started megestrol and an herbal medicine, soursop (Annona muricata). Six months later, AFP markedly decreased (28 ng/mL) and abdominal MRI showed decreasing size and number of lesions. At 5 years of follow-up, he has no evidence of HCC. Spontaneous regression of HCC is a rare condition and the underlying mechanism is unclear. In this case there is a temporal relation between the start of megestrol and Annona muricata and HCC regression.

  • hepatic cancer
  • cirrhosis
  • gastrointestinal system
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  • Contributors All authors contributed to the manuscript concept and design. MC-S drafted the manuscript and reviewed the literature. AG selected and reviewed imaging studies. AOF and JN were responsible for critical review of the manuscript and approval of the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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