“The host’s role in hepatocellular carcinoma development: A case of regression from probable malignancy to a benign lesion”

Acute and chronic stress both has a profound impact on the immune system and subsequent disease development. However, it is important to understand that their effects are opposite. Acute stress leads to the release of pro-inflammatory cytokines which stimulates the immune system whereas chronic stress leads to immune system suppression. Chronic suppression can lead to viral activation, disease progression and cancer development, specifically, hepatocellular carcinoma. We present a case in which a patient with hepatitis B virus and cirrhosis developed a LI-RADS 4 (probably hepatocellular carcinoma) lesion during a period of substantial stress. Fortunately, his stress was able to be relieved, and he was subsequently found to have regression of this probably malignant lesion to a benign lesion. It is germane for physicians to understand the large impact stress can have on disease development and progression in an effort to curtail this by providing patients with appropriate psychological and emotional support. *Correspondence to: Hie-Won Hann, MD, FAASLD, Director, Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, 1025 Walnut Street, Philadelphia, PA 19107, USA, Tel: 215-955-5806, E-mail: hie-won.hann@jefferson.edu