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Chhabra R, Vidushi A, Rajpurohit S, Singh J, Osama MA. Spontaneous Tumor Lysis Syndrome in a Case of Hepatocellular Carcinoma with Sarcomatoid Differentiation. Indian J Surg Oncol 2024; 15:370-374. [PMID: 38741637 PMCID: PMC11088581 DOI: 10.1007/s13193-024-01895-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/02/2024] [Indexed: 05/16/2024] Open
Abstract
Sarcomatoid hepatocellular carcinoma is a rare histologic variant of primary liver cancer comprising of malignant spindle cells and typical hepatocellular carcinoma (HCC). In terms of clinical presentation, they usually exhibit extensive tumor burden due to their larger size and a metastatic disease at the time of diagnosis as compared to conventional HCC. Tumor lysis syndrome is an oncological emergency, usually seen after cytotoxic chemotherapy in haematological malignancies. Here, we highlight a case of 76-year old male with no comorbidities, presenting with an excruciating backache and a paravertebral soft tissue mass and multiple osteolytic lesions, was clinically suspected to be a plasma cell neoplasm. On further evaluation, the patient was diagnosed of a sarcomatoid variant of hepatocellular carcinoma. This report showcases multiple rare findings by the presence of non-specific symptoms, non-cirrhotic liver, normal serum alpha protein levels and the occurrence of a spontaneous tumor lysis syndrome in a solid malignancy.
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Affiliation(s)
- Raja Chhabra
- Department of Medical Oncology, BLK-MAX Super Speciality Hospital, Pusa Road, New Delhi, India
| | - Aditya Vidushi
- Department of Medical Oncology, BLK-MAX Super Speciality Hospital, Pusa Road, New Delhi, India
| | - Sajjan Rajpurohit
- Department of Medical Oncology, BLK-MAX Super Speciality Hospital, Pusa Road, New Delhi, India
| | - Jasbir Singh
- Department of Pathology, BLK-MAX Super Speciality Hospital, Pusa Road, New Delhi, India
| | - Md Ali Osama
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
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Liang B, Huang T, Kuang SL, Xie GY, Liu TQ, Chen YY. Surgery after combination therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody in sarcomatoid hepatocellular carcinoma: case report and literature review. Front Oncol 2023; 13:1212013. [PMID: 37869099 PMCID: PMC10585252 DOI: 10.3389/fonc.2023.1212013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Although surgery is the preferred treatment for sarcomatoid hepatocellular carcinoma (SHC), the prognosis remains considerably poor due to early postoperative recurrence and metastasis. Reports on surgery after combined treatment with a tyrosine kinase inhibitor and anti-programmed cell death (PD)-1 antibody are unavailable. Case presentation A 69-year-old male patient with SHC was admitted to our hospital for treatment of a liver tumor that was detected on ultrasonography. Abdominal computed tomography with triple-phase enhancement revealed a lesion in the right hepatic lobe that measured 86.0 mm × 75.0 mm × 71.0 mm. Biopsy revealed a pathological diagnosis of liver sarcoma or sarcomatoid carcinoma. The patient subsequently received transcatheter arterial chemo-embolization, as he did not consent to surgery. More than two months later, he received a combination of lenvatinib with camrelizumab, as computed tomography showed an increase in the lesion size (to 123.0 mm × 90.0 mm × 80.0 mm) and lateral growth posterior to the upper pole of the right kidney. Liver resection was performed after 6 months of systemic therapy; pathological examination confirmed a diagnosis of SHC and showed extensive necrosis of tumor cells. Combined treatment with lenvatinib and camrelizumab was continued for 6 months after surgery. The patient has survived for over 24 months after initial diagnosis and is currently tumor-free. Conclusion Combined systemic therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody may represent a feasible treatment strategy for improving resectability in cases of unresectable SHC. The outcomes with this combination may also be explored in cases of resectable SHC that have a high-risk of recurrence; this may improve the therapeutic effect.
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Affiliation(s)
- Bin Liang
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tao Huang
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shao-Lei Kuang
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guang-Yuan Xie
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tian-Qi Liu
- Department of General Surgery, the Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yuan-Yuan Chen
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Li R, Qu W, Liu Q, Tan Y, Zhang W, Hao Y, Jiang N, Mao Z, Ye J, Jiao J, Gao Q, Cui B, Dong T. Development and validation of a deep learning survival model for cervical adenocarcinoma patients. BMC Bioinformatics 2023; 24:146. [PMID: 37055729 PMCID: PMC10103498 DOI: 10.1186/s12859-023-05239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/20/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The aim was to develop a personalized survival prediction deep learning model for cervical adenocarcinoma patients and process personalized survival prediction. METHODS A total of 2501 cervical adenocarcinoma patients from the surveillance, epidemiology and end results database and 220 patients from Qilu hospital were enrolled in this study. We created our deep learning (DL) model to manipulate the data and evaluated its performance against four other competitive models. We tried to demonstrate a new grouping system oriented by survival outcomes and process personalized survival prediction by using our DL model. RESULTS The DL model reached 0.878 c-index and 0.09 Brier score in the test set, which was better than the other four models. In the external test set, our model achieved a 0.80 c-index and 0.13 Brier score. Thus, we developed prognosis-oriented risk grouping for patients according to risk scores computed by our DL model. Notable differences among groupings were observed. In addition, a personalized survival prediction system based on our risk-scoring grouping was developed. CONCLUSIONS We developed a deep neural network model for cervical adenocarcinoma patients. The performance of this model proved to be superior to other models. The results of external validation supported the possibility that the model can be used in clinical work. Finally, our survival grouping and personalized prediction system provided more accurate prognostic information for patients than traditional FIGO stages.
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Grants
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- No.2020SDUCRCA007 Clinical Research Center of Shandong University
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- QDKY2020BS04 Scientific Research Foundation of Qilu Hospital of Shandong University(Qingdao)
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
- ZR2021QH107 Natural Science Foundation of Shandong Province, China
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Affiliation(s)
- Ruowen Li
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Wenjie Qu
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Qingqing Liu
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Yilin Tan
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Wenjing Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong Province, China
| | - Yiping Hao
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Nan Jiang
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Zhonghao Mao
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Jinwen Ye
- Cheeloo College of Medicine, Shandong University, No. 44 Wenhua West Road, Lixia District, Jinan, 250012, Shandong Province, China
| | - Jun Jiao
- Department of Obstetrics and Gynaecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Qun Gao
- Department of Obstetrics and Gynecology, Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Shinan District, Qingdao, 266555, Shandong Province, China
| | - Baoxia Cui
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong Province, China.
| | - Taotao Dong
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong Province, China.
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Ke C, Dai S, Xu F, Yuan J, Fan S, Chen Y, Yang L, Li Y. Cuproptosis regulatory genes greatly contribute to clinical assessments of hepatocellular carcinoma. BMC Cancer 2023; 23:25. [PMID: 36611155 PMCID: PMC9824945 DOI: 10.1186/s12885-022-10461-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a common abdominal cancer with dissatisfactory therapeutic effects. The discovery of cuproptosis lights on new approach for cancer treatment and assessment. So far, there is extremely limited research investigating the roles of cuproptosis-related (CR) genes in cancers. METHODS A novel CR risk signature was constructed using the Lasso regression analysis. Its prognostic value was assessed via a series of survival analyses and validated in three GEO cohorts. The effects of CR risk signature on tumor immune microenvironment (TIM) were explored through CIBERSORT, ESTIMATE, and ssGSEA algorithms. Using GESA, we investigated its impacts on various metabolism process. The somatic mutation features of CR signature genes were also explored via cBioPortal database. Using tumor mutation burden, expressions of immune checkpoints, TIDE score, IMvigor 210 cohort, and GSE109211 dataset, we explored the potential associations of CR risk score with the efficacy of immune checkpoint inhibitors (ICIs) and sorafenib. Finally, the biofunctions of DLAT in HCC cells were ascertained through qPCR, immunohistochemistry, colony formation, and Transwell assays. RESULTS FDX1, DLAT, CDKN2A and GLS constituted the CR risk signature. CR risk signature possessed high prognostic value and was also applicable to three validation cohorts. Meanwhile, it could improve the accuracy and clinical making-decision benefit of traditional prognostic model. Moreover, high CR risk was indicative of unfavorable anti-tumor immune response and active metabolisms of glycolysis and nucleotide. As for therapeutic correlation, CR risk score was a potential biomarker for predicting the efficacy of ICIs and sorafenib. Through qPCR and immunohistochemistry detection in clinical samples, we reconfirmed DLAT was significantly upregulated in HCC samples. Overexpression of DLAT could promote the proliferation, migration, and invasion of HepG2 and HuH-7 cells. CONCLUSIONS The novel CR risk signature greatly contributed to the clinical assessment of HCC. Cuproptosis regulatory gene DLAT possessed cancer-promoting capacities and was expected to be a promising therapeutic target for HCC.
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Affiliation(s)
- Changwei Ke
- grid.452672.00000 0004 1757 5804Department of Emergency, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Shejiao Dai
- grid.452672.00000 0004 1757 5804Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, No. 157, West Five Road, Xi’an, 710004 Shaanxi China
| | - Fangshi Xu
- grid.43169.390000 0001 0599 1243Department of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Jia Yuan
- grid.452672.00000 0004 1757 5804Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, No. 157, West Five Road, Xi’an, 710004 Shaanxi China
| | - Shuting Fan
- grid.452672.00000 0004 1757 5804Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, No. 157, West Five Road, Xi’an, 710004 Shaanxi China
| | - Yang Chen
- grid.43169.390000 0001 0599 1243Department of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Longbao Yang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, West Five Road, Xi'an, 710004, Shaanxi, China. .,Department of Outpatient, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
| | - Yong Li
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, West Five Road, Xi'an, 710004, Shaanxi, China. .,Department of Outpatient, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
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Fencer MG, Davis CH, Liu J, Galan MA, Spencer KR. Disease Control Achieved Using Atezolizumab + Bevacizumab in a Patient With Sarcomatoid Hepatocellular Carcinoma (SHCC), a Rare Variant Excluded From the IMbrave150 Trial. J Investig Med High Impact Case Rep 2022; 10:23247096221129470. [PMID: 36541195 PMCID: PMC9791267 DOI: 10.1177/23247096221129470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Sarcomatoid hepatocellular carcinoma (SHCC) is a rare variant of liver cancer that lacks treatment options. The IMbrave trail demonstrated the efficacy of atezolizumab and bevacizumab (A + B) in patients with unresectable hepatocellular carcinoma but excluded patients with sarcomatoid variants. Herein, we describe a case of disease control achieved using the IMbrave regimen in a patient with sarcomatoid hepatocellular carcinoma.
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Affiliation(s)
- Maria G. Fencer
- Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ, USA,Rutgers New Jersey Medical School, Newark, USA
| | - Catherine H. Davis
- Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ, USA,Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - Jieqi Liu
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | | | - Kristen R. Spencer
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA,Kristen R. Spencer, DO, MPH, Division of Medical Oncology, New York University, 160 E 34th St, New York NY 10016, USA.
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Sadiq AM, Mjemmas MG, Sadiq AM, Nkya GZ. Sarcomatoid hepatocellular carcinoma in a young African female. SAGE Open Med Case Rep 2021; 9:2050313X211052452. [PMID: 34646567 PMCID: PMC8504208 DOI: 10.1177/2050313x211052452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/23/2021] [Indexed: 12/24/2022] Open
Abstract
Sarcomatoid hepatocellular carcinoma is a rare primary malignant liver cancer. The pathogenesis is unclear; however, the risk factors may be similar to that of conventional hepatocellular carcinoma. We present an 18-year-old female who was admitted due to generalized tonic-clonic convulsions. On examination, we palpated a large non-tender mass in the right upper quadrant. An abdominal computed tomography identified it as hepatocellular carcinoma, and spindle-shaped cells were seen on histopathology. She was counseled on her prognosis but opted for local herbal medications rather than chemotherapy, but unfortunately passed away. We present a rare subtype of hepatocellular carcinoma in a young female which is commonly seen in males above the age of 50 years, and despite its grade and stage, overall survival is poor.
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Affiliation(s)
- Abid M Sadiq
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Minael G Mjemmas
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Adnan M Sadiq
- Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Gilbert Z Nkya
- Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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