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Combined immune checkpoint inhibitors of CTLA4 and PD-1 for hepatic melanoma of unknown primary origin: A case report

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World Journal of Clinical Cases 2021年第11期9卷 2641-2648页

作者： An-Che Cheng Yi-Jia Lin Sung-Hua Chiu Yu-Lueng Shih Department of Internal Medicine Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Radiology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Internal Medicine Division of GastroenterologyTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND Melanoma is uncommonly found in lymph nodes,subcutaneous tissue,or visceral organs without a primary lesion,where it is identified as metastatic melanoma with unknown primary(MUP).Hepatic MUP is extremely rare and has a poor *** is limited information on its pathogenesis,clinical and imaging features,and pathological *** are no guidelines for the use of immune checkpoint inhibitors(ICIs)in hepatic MUP,and the treatment outcome has rarely been *** SUMMARY A 42-year-old woman presented to our hospital with hepatic tumors found incidentally during a routine ***-enhanced abdominal computerized tomography showed multiple mass lesions in the *** results revealed melanoma,which was confirmed by immunohistochemical staining for HMB-45(+),Melan-A(+),S-100(+),and SOX10(+).There was no evidence of primary cutaneous,ocular,gastrointestinal,or anal lesion on a comprehensive *** patient was diagnosed with hepatic *** received combined antibodies against cytotoxic T-lymphocyte-associated antigen 4(CTLA-4,ipilimumab)and programmed death protein-1(PD-1,nivolumab).She died of hepatic failure 9 mo after hepatic MUP was *** the first case of hepatic MUP treated with combined ipilimumab and nivolumab,who showed better outcome than previous *** ICIs of PD-1 and CTLA-4 may be considered as the first-line therapyfor patients with hepatic MUP.

关键词： Metastatic melanoma with unknown primary Liver metastasis Immune checkpoint inhibitor programmed death protein-1 Cytotoxic T-lymphocyte-associated antigen 4 Case report

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Trends of rapamycin in survival benefits of liver transplantation for hepatocellular carcinoma

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 953-966页

作者： Yang Zhao Yu Liu Lin Zhou Guo-Sheng Du Qiang He Department of Hepatobiliary and Pancreaticosplenic Surgery Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Department of Hepato-Pancreato-Biliary Surgery Chinese PLA General HospitalBeijing 100853China

The proportion of liver transplantation(LT)for hepatocellular carcinoma(HCC)has kept on increasing over the past years and account for 20%-40%of all ***-transplant HCC recurrence is considered the most important factor affecting the long-term survival of *** use of different types of immunosuppressive agents after LT is closely associated with an increased risk for HCC *** most commonly used conventional immunosuppressive drugs include the calcineurin inhibitors tacrolimus(FK506)and mammalian target of rapamycin inhibitor rapamycin(RAPA).Compared with tacrolimus,RAPA may carry an advantage in survival benefit because of its anti-tumor ***,no sufficient evidence to date has proven that RAPA could increase long-term recurrence-free survival and its anti-tumor mechanism of combined therapy remains incompletely *** this review,we will focus on recent advances in clinical application experience and basic research results of RAPA in patients undergoing LT for HCC to further guide the clinical practice.

关键词： Rapamycin Hepatocellular carcinoma Liver transplantation Lenvatinib programmed death protein-1 Huaier granule

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