Still be alert to lung metastasis of liver cancer after liver resection

Mr. Wang had a liver cancer resection a year ago. As his disease was discovered early, the doctor said the prognosis was good. Therefore, he went home to recuperate after the operation and regularly went to the hospital for other treatments or examinations. During a recent examination, the doctor found that Mr. Wang's serum alpha-fetoprotein was positive, so he immediately performed a liver examination, but no liver space-occupying lesions were found.

Considering the possibility of lung metastasis, an X-ray chest film examination revealed tiny nodules in the lung field. A CT scan later confirmed that it was lung metastasis of liver cancer.

There are many cases like Mr. Wang. Liver cancer resection does not mean that you can sit back and relax. Although the lesion has been removed, it is very likely to recur or metastasize to distant sites. Therefore, regular follow-up is particularly important. The lungs are the site where liver cancer is prone to metastasis. After liver cancer resection, chest X-rays should be checked regularly. Usually, chest X-rays are done every six months.

This is because lung X-rays are more sensitive and accurate in detecting lung metastases. Lung metastases appear on X-rays as small round nodules in the lung fields. Most are multiple, but a few are solitary. They are more common in the outer fields of the lungs, more common in the lower lung fields than in the upper lung fields.

However, sometimes during postoperative follow-up, the patient's alpha-fetoprotein level is elevated, but liver imaging examinations have not found recurrence, and chest X-rays have not found lung metastases. At this time, micrometastases in the lungs should be considered, and a thin-layer CT scan of the lungs is needed to determine whether metastasis has occurred.