Contrast-enhanced Ultrasonography Features for Diagnosing Pseudoprogression of Hepatocellular Carcinoma with Immunotherapy: A Case Report of the Response after Pseudoprogression

A male patient in his 70s with recurrent hepatocellular carcinoma (HCC) after surgery received atezolizumab plus bevacizumab (Atezo+Bev) therapy. Initial computed tomography (CT) revealed tumor growth along with an increase in tumor markers, and contrast-enhanced ultrasonography (CEUS) showed multip...

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Bibliographic Details
Published in:Internal Medicine 2024/04/15, Vol.63(8), pp.1093-1097
Main Authors: Otake, Shin, Ota, Yu, Aso, Kazunobu, Okada, Mitsuyoshi, Hayashi, Hidemi, Hasebe, Takumu, Nakajima, Shunsuke, Sawada, Koji, Fujiya, Mikihiro, Okumura, Toshikatsu
Format: Article
Language:English
Subjects:
Bevacizumab
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Cheese
Computed tomography
Contrast Media
contrast-enhanced ultrasonography
Hepatocellular carcinoma
Humans
Immunotherapy
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Male
pseudoprogression
Tumor markers
Tumors
Ultrasonography - methods
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Summary:A male patient in his 70s with recurrent hepatocellular carcinoma (HCC) after surgery received atezolizumab plus bevacizumab (Atezo+Bev) therapy. Initial computed tomography (CT) revealed tumor growth along with an increase in tumor markers, and contrast-enhanced ultrasonography (CEUS) showed multiple round avascular areas within the nodules with an appearance similar to a slice of Swiss cheese. Continuation of immunotherapy with consideration of the potential for pseudoprogression produced a dramatic response. Although it is difficult to distinguish between true progression and pseudoprogression, the Swiss cheese-like appearance on CEUS may be important for the early diagnosis of pseudoprogression.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.2349-23