Patient Mo, female, 58 years old. She underwent hepatectomy five years ago in a famous tertiary hospital in Guangzhou for liver cancer and recovered well after the operation.
She recovered well after the operation. She was regularly reviewed according to the doctor’s prescription and had no abnormality. Six months ago, the AFP was found to be elevated during the follow-up examination, but no mass was found after CT examination. AFP was rechecked monthly and kept rising. After checking CT, MR, etc. at four tertiary hospitals in the city, no clear mass was found, so he came to our office. Huang Gang, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Guangzhou Medical University
No positive signs on physical examination.
Checking the results of external examination, AFP increased monthly in the past six months, and no small mass or enlarged lymph nodes were found in a total of six CTs and MRs.
Judgment: recurrence of hepatocellular carcinoma.
Difficulty: identify the recurrent lesion.
He was personally brought to the ultrasound examination room and CT room and watched the examination together. After repeated examinations, a mass less than 1 cm in size (microscopic hepatocellular carcinoma) was seen next to the original surgical site, and he was immediately hospitalized for surgery.
The microscopic liver cancer was removed surgically and he was discharged from the hospital after the operation.
No recurrence was seen in nearly two years since the follow-up.
Hepatocellular carcinoma smaller than 1 cm is difficult to detect and requires extensive clinical experience and imaging knowledge.
If patients (with or without surgical history) have elevated AFP, they should all pay high attention to it, observe it closely, and examine it repeatedly. In the case of excluding medical causes causing it, there must be a lesion that we need to find in order to treat it in time.