• Internal medicine · Apr 2024

    Case Reports

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

    • Shin Otake, Yu Ota, Kazunobu Aso, Mitsuyoshi Okada, Hidemi Hayashi, Takumu Hasebe, Shunsuke Nakajima, Koji Sawada, Mikihiro Fujiya, and Toshikatsu Okumura.
    • Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan.
    • Intern. Med. 2024 Apr 15; 63 (8): 109310971093-1097.

    AbstractA 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.

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