A 60-year-old man received
interferon/
ribavirin combination
therapy for
chronic hepatitis C in 2002 and achieved sustained virological response. In 2008, a
hepatocellular carcinoma (HCC) with a diameter of 60 mm appeared and surgical resection was performed. In March 2011, the patient was referred to our hospital because of portal lymph node swelling. Abdominal ultrasonography, dynamic CT and dynamic MRI did not show any
tumors in the liver, but revealed portal lymph node swelling (18 × 11 mm). Taking the elevation of serum des-γ-carboxy
prothrombin and
alpha-fetoprotein levels, including the
lectin-bound type, into consideration, we made the diagnosis of HCC
metastasis to the portal lymph node. We started
sorafenib therapy at a dose of 800 mg/day, but discontinued it after 11 days due to grade 3 hand-foot skin reaction and
rash. In spite of treatment termination, portal lymph node swelling disappeared and the serum des-γ-carboxy
prothrombin and
alpha-fetoprotein levels normalized. We considered that our patient achieved complete response to
sorafenib according to the Response Evaluation Criteria in Solid Tumors (RECIST). The patient maintains remission up to June 2012, more than 1 year after the discontinuation of
sorafenib therapy.
Sorafenib could be a good option for unresectable or recurrent HCC.