Purpose: Management of the unexplained AFP elevation after transplantation. F18 FDG PET/CT may not be helpful to detect post-transplant brain metastasis of hepatocellular carcinoma (HCC).

Case Report: A-61-year old male patient with HBV related HCC have undergone living donor liver transplantation after successfully downstaging. AFP level started to increase on Post-transplant one year and there was no detectable metastases on PET/CT, abdominal thorax tomography. Patient admitted to hospital with confusion and seizure on post-transplant 16th month and diagnosed brain metastasis by brain tomography. Surgical resection was performed but the patientd died on post-transplant 20th month.

Conclusion: In the unexplained elevation of AFP after transplantation, it is beneficial to keep brain metastases in mind and perform cranial scanning with conventional imaging methods (CT, MRI) rather than FDG PET.

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Source
http://dx.doi.org/10.1007/s12029-021-00767-yDOI Listing

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