Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy: A case report and review of literature

Figure 1 Contrast-enhanced computed tomography and magnetic resonance images of the patient. A: Axial images of the arterial phase before treatment; B: Axial images of the portal phase before treatment; C: Axial images of the arterial phase after 3 months of treatment; D: Axial images of the portal phase after 3 months of treatment; E: Sagittal sectional magnetic resonance image (MRI) images before surgery; F: Cross-sectional MRI images before surgery.

Figure 2 Three-dimensional computed tomography reconstruction of the liver and volume calculation. A: The total liver volume was 2764 cm³ and the residual was 786 cm³ before treatment; B: After three months of conversion therapy, the total liver volume was 1975 cm³ and the residual was 650 cm³.

Figure 3 Angiography with the iodine contrast agent. A: Before the first transcatheter arterial chemoembolization (TACE) treatment on November 19, 2021; B: After the first TACE treatment on November 19, 2021; C: Before the second TACE treatment on December 10, 2021; D: After the second TACE treatment on December 10, 2021; E: Before the third TACE treatment on December 31, 2021; F: After the third TACE treatment on December 31, 2021.

Figure 4 Changes in thyroid function indices with treatment time.

Figure 5 Changes in body mass index over time. BMI: Body mass index.

Figure 6 Changes in laboratory indices over the time of treatment.

Figure 7 Histopathology of tumor tissue after conversion therapy and resection. A and B: At low magnification (50 ×) and high magnification (200 ×), the primary lesion showed massive coagulation necrosis with lymphocyte infiltration; C and D: At low magnification (50 ×) and high magnification (200 ×), hyperplasia of the surrounding fibrous tissue and lymphocyte infiltration were visible in nontumor normal tissues; E: Macroscopic view of the patient's intrahepatic lesion.

Figure 8 Timeline of patient history development.