Unresectable HCC with Extrahepatic Involvement
Unresectable HCC with Extrahepatic Involvement
A 77-Year-Old Male With Unresectable HCC and Extrahepatic Involvement
- History and physical exam
- An otherwise healthy, 77-year-old Caucasian male with a history of alcohol use
- Presented to his PCP complaining of abdominal pain, fatigue and an unexplained 10-lb weight loss
- Currently consumes 3-4 alcoholic drinks per day
- ECOG PS 0
- Imaging
- CT scan: 4.5-cm hepatic lesion with arterial hypervascularity, portal venous washout, and a pseudocapsule indicative of hepatocellular carcinoma; no evidence of vascular invasion
- Bone scan: left-sided iliac mass (3.1 cm)
- Chest CT: clear
- Diagnosis: unresectable HCC with extrahepatic involvement
- BCLC stage C
- Child-Pugh A
- AFP Level: 3548.4 ng/mL
- Weight: 72 kg
- Lenvatinib 12 mg QD was initiated.
- He experienced modest weight loss and reported loss of appetite for which he was referred for nutritional therapy
- Imaging at 16 weeks: partial response (0.5 cm)
- 8 months after initiation of therapy: treatment discontinued due to disease progression
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