A case of hepatocellular carcinoma with disappearance of lymph node metastasis after sorafenib administration

Abstract

We describe a patient with recurrent hepatocellular carcinoma (HCC) in the remnant liver and lymph node metastasis after hepatectomy. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) showed an increase in FDG accumulation in a lymph node around the head of the pancreas but not in liver tumors. One year after sorafenib administration, neither the lymph node nor the intrahepatic tumors exhibited FDG accumulation. Although two known intrahepatic tumors became enlarged, no new intra- or extrahepatic lesions were detected. Considering that the patient had achieved down-staging of HCC, additional transarterial chemoembolization and radiofrequency ablation (RFA) were performed. The patient is currently alive without recurrence at 10 months after RFA. In conclusion, FDG-PET/CT is useful not only for the detection of extrahepatic metastasis, but also for the assessment of systemic chemotherapy in patients with advanced HCC.