Ten-Year Structural Reversal of Severe Nodular Cirrhosis with Hepatic Atrophy in a Heavy Manual Laborer After Intermittent Neo-Chinese Medicine Treatment: A Case Report

Abstract Background Reversing established cirrhosis with hepatic atrophy and severe nodularity is generally considered extremely difficult. We report a case of a heavy manual laborer with active, severe nodular cirrhosis and hepatic atrophy who achieved a decade-long structural reversal following intermittent Neo-Chinese Medicine treatment, avoiding decompensation. Case Presentation: A 61-year-old male farmer and bricklayer with a 10-year history of hepatitis B cirrhosis presented in February 2014 with mild ALT elevation (78.0 U/L) and abnormal liver fibrosis markers (hyaluronic acid 169 µg/L), indicating active cirrhosis. Baseline MRI revealed a shrunken liver with multiple nodular signals. Baseline FibroScan showed a liver stiffness of 25.2 kPa. Without timely intervention, rapid progression to decompensated cirrhosis was highly anticipated. He received intermittent Neo-Chinese Medicine treatment for 12 years while continuing heavy manual labor. His liver fibrosis markers normalized by the second follow-up. Serial FibroScan assessments demonstrated a continuous, stepwise regression of liver stiffness: 19.6 kPa (2015), 14.8 kPa (2016), 11.6 kPa (2017), 10.2 kPa (2018), and finally 7.2 kPa (2024). A follow-up MRI in January 2024 showed a normal liver size and morphology. Remarkably, over the 12-year period, the patient experienced no episodes of decompensation and maintained his heavy physical work. Conclusion This case demonstrates that active severe nodular cirrhosis with hepatic atrophy can undergo profound structural reversal. The effective hydrolysis of fibrosis and orderly regeneration of hepatocytes prevented decompensation and normalized liver morphology, highlighting the potential of Neo-Chinese Medicine in real-world settings.