Aa
HCC, post liver transplant...
Hi.
Being 3 months post transplant...transplant was due to cirhorssis, hepatitis B and HCC...a CT scan of abdomen and pelvis as well as CT scan of chest is scheduled for August. Anxiety is building up to get scans done as well as results. Prior to transplant, there were 2 suspicious lesions in the right lung (8mm ground glass nodule in right upper lobe and a lobulated nodule (not sure of size) in the lower lung). Now, the fear sets in that the suspicious lesions may be mestastic cancer from the HCC in the liver.
HCC in the liver was one lesion, measuring 1.8cm (according to pathology report) with no vessel invasion. FYI...The HCC was also treated with chemo embolization 2x prior to transplant and was found to be 80% non active (due to the chemo embolization).
What are the chances that the HCC prior to transplant metastized to the lungs??? Does HCC react differently/aggressively with Hepatitis B versus Hepatitis C? Is it possible that the HCC spread to the lungs although the pathology report of old liver shows no vessel invasion??? Help/advice us GREATLY appreciated!!!
Being 3 months post transplant...transplant was due to cirhorssis, hepatitis B and HCC...a CT scan of abdomen and pelvis as well as CT scan of chest is scheduled for August. Anxiety is building up to get scans done as well as results. Prior to transplant, there were 2 suspicious lesions in the right lung (8mm ground glass nodule in right upper lobe and a lobulated nodule (not sure of size) in the lower lung). Now, the fear sets in that the suspicious lesions may be mestastic cancer from the HCC in the liver.
HCC in the liver was one lesion, measuring 1.8cm (according to pathology report) with no vessel invasion. FYI...The HCC was also treated with chemo embolization 2x prior to transplant and was found to be 80% non active (due to the chemo embolization).
What are the chances that the HCC prior to transplant metastized to the lungs??? Does HCC react differently/aggressively with Hepatitis B versus Hepatitis C? Is it possible that the HCC spread to the lungs although the pathology report of old liver shows no vessel invasion??? Help/advice us GREATLY appreciated!!!
MEDICAL PROFESSIONAL
i dont think that this is a metastatic lesion also based on the histology of the HCC noted on the liver explant
Opps...also...it says "mildly avid uptake with SUV of 2.3"...given that the word "mildly" is there, is that a good thing???
Oh...then a Pet scan is NOT a good test to help determine if HCC has spread else where in the body??? Should I be worried that the nodule in the LUNG, which has an SUV of 2.3 (8mm ground glass nodule) may be mestatic spread of the HCC? Sorry for so many questions...extremely anxious about this.
MEDICAL PROFESSIONAL
HCC anywhere in the body typically does not
Oh...just curious...why doesn't metastic HCC in the lung pick up the Pet tracer???
Thank you so much Dr. Schiano for all your responses. You are extremely helpful.
MEDICAL PROFESSIONAL
metastatic HCC to lung should not pick up tracer. The likelihood of this small HCC metastasizing is incredibly low
Oh (forgot to mention in my last post)...the SUV uptake of 2.3 was for the 8mm ground glass nodule in the LUNG, not in the liver.
Thank you so much for your quick response.
When you are referring to "HCC do not actually take up Pet tracer", do you mean HCC within the liver doesn't take up Pet tracer or HCC that has metasized else where in the body (lungs) doesn't take up Pet tracer?
In your experience, do patients with a history of HCC (as in my case, one 1.8cm lesion, treated via chemo embolization) tend to get mestasized cancer from the HCC?
Although lung nodules are common in the general population, I worry bc of my history of the one HCC tumor in the liver AND also that the Pet scan uptake was an SUV of 2.3.
Sorry for so many questions :)
When you are referring to "HCC do not actually take up Pet tracer", do you mean HCC within the liver doesn't take up Pet tracer or HCC that has metasized else where in the body (lungs) doesn't take up Pet tracer?
In your experience, do patients with a history of HCC (as in my case, one 1.8cm lesion, treated via chemo embolization) tend to get mestasized cancer from the HCC?
Although lung nodules are common in the general population, I worry bc of my history of the one HCC tumor in the liver AND also that the Pet scan uptake was an SUV of 2.3.
Sorry for so many questions :)
MEDICAL PROFESSIONAL
successfully treated 80% is the necrosis that I was referring to. HCC do not actually take up PET tracer--I do not think the lung nodules (fairly common in the general population) are related to HCC--I am fairly confident of this. Smaller HCC rarely metastasize
Thank you so much Dr. Schiano for your response. I have a few more questions...
What do you mean by "post-treatment necrosis"?
The suspicious lung nodules were found on a CT scan in January which was 2 weeks after the 2nd chemo embolization. In February, I requested a Pet Scan, which showed that the 8mm ground glass nodule had an SUV uptake of 2.3 and the lobulated nodule was not clearly visualized on the Pet Scan. In April, I had my liver transplant. 3 or 4 chest xrays have been taken post transplant. Next month, a CT is scheduled.
These lung nodules have been a huge concern for me...I worry that they are a result of the HCC having metasized.
How aggressive is HCC? Is it known to spread quickly to the lungs? Is it possible that being that there was only 1 HCC tumor and it was 1.8cm, it was confined only to the liver? Does a smaller HCC lesion metasize the same rate/way than a larger HCC tumor?
The HCC lesion was treated via chemo embolization 2x and was found to be 80% successfully treated (per pathology report)
I am so worried :-(
What do you mean by "post-treatment necrosis"?
The suspicious lung nodules were found on a CT scan in January which was 2 weeks after the 2nd chemo embolization. In February, I requested a Pet Scan, which showed that the 8mm ground glass nodule had an SUV uptake of 2.3 and the lobulated nodule was not clearly visualized on the Pet Scan. In April, I had my liver transplant. 3 or 4 chest xrays have been taken post transplant. Next month, a CT is scheduled.
These lung nodules have been a huge concern for me...I worry that they are a result of the HCC having metasized.
How aggressive is HCC? Is it known to spread quickly to the lungs? Is it possible that being that there was only 1 HCC tumor and it was 1.8cm, it was confined only to the liver? Does a smaller HCC lesion metasize the same rate/way than a larger HCC tumor?
The HCC lesion was treated via chemo embolization 2x and was found to be 80% successfully treated (per pathology report)
I am so worried :-(
MEDICAL PROFESSIONAL
with the histology that you describe, the size of the lesion and the fact that there was this much post-treatment necrosis, it is highly unlikely that these lung lesions are of concern. good luck.
MEDICAL PROFESSIONAL
testing
MEDICAL PROFESSIONAL
testing--will answer formally soon
MEDICAL PROFESSIONAL
heheh
You are reading content posted in the Liver Transplant Forum
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
