Spontaneous regression of hepatocellular carcinoma with reduction in angiogenesis‐related cytokines after treatment with sodium‐glucose cotransporter 2 inhibitor in a cirrhotic patient with diabetes mellitus

摘要

Spontaneous regression of hepatocellular carcinoma (HCC) is a rare event, and the pathogenesis remains unclear. Here, we present a case of spontaneous regression of HCC after treatment with sodium‐glucose cotransporter 2 inhibitor (SGLT2i) in a cirrhotic patient with diabetes mellitus (DM). A 68‐year‐old man regularly visited our hospital for follow‐up of HCC after treatment with transcatheter arterial chemoembolization, and management of liver cirrhosis and type 2 DM. Contrast‐enhanced computed tomography scan showed a hypervascular tumor in the liver and elevated serum α‐fetoprotein levels, indicating the recurrence of HCC. Simultaneously, the hemoglobin A1c value increased to 8.0%; therefore, he was treated with SGLT2i (canagliflozin 100?mg/day). Ten weeks after the initiation of SGLT2i treatment, he was admitted to our hospital for treatment of recurrent HCC. However, the hypervascular tumor had disappeared, and the elevated serum α‐fetoprotein level had decreased to normal limits, indicating spontaneous regression of HCC. In addition, an angiogenesis array analysis revealed downregulated protein expression of matrix metalloproteinase‐8, angiopoietin‐1/2, platelet‐derived growth factor‐AA, and prolactin at 10?weeks after SGLT2i treatment. In this report, we first describe a case of spontaneous regression of HCC with reduction in angiogenesis‐related cytokines after SGLT2i treatment.