Can a 1.5 cm Liver Tumor Cause AFP Levels to Exceed 400?

Q: Can a 1.5 cm Liver Tumor Cause AFP Levels to Exceed 400?

Hello： It is not possible to estimate cancer markers based on tumor size. <br>If it cannot be determined whether there is metastasis, we should first address the currently obvious targets and observe how the fetal protein responds. <br>X-rays may have some blind spots, or the tum

Can a liver tumor approximately 1.5 centimeters in size cause the AFP (alpha-fetoprotein) level to rise to over 400?

Hello Dr.
Tsai,
My father was first diagnosed with a liver tumor in 2006 and underwent radiofrequency ablation.
For the following years, he was monitored and everything was fine.
However, in 2015, his alpha-fetoprotein (AFP) levels increased, and upon further investigation, a suspected recurrence of the liver tumor was found.
The AFP levels were around 50 to 60, and he underwent another radiofrequency ablation.
The following year, in 2016, his AFP levels continued to rise, but both CT and MRI scans did not reveal any tumors in the liver.
It wasn't until around October 2016, when his AFP reached over 300, that a "suspected" liver tumor was identified, leading to an exploratory laparoscopic surgery for potential resection.
However, during the laparoscopic procedure, numerous tumors were found on the peritoneum.
(Note: Other examinations showed no organ metastasis, and it is suspected that the radiofrequency ablation in 2015 may have caused the cancer cells to scatter in the abdominal cavity.) That same year, he underwent aggressive "debulking surgery and intraperitoneal hyperthermic chemotherapy" to remove the tumors from the peritoneum.
After the surgery, his AFP levels dropped to around 10, but over time, they have gradually increased again.
Currently, follow-up results from an MRI show a 1.5 cm tumor in the liver.

I would like to ask you, Dr.
Tsai:
Q1.
Could this 1.5 cm tumor cause the AFP levels to spike to over 400?
Q2.
Is it possible that there are new issues on the peritoneum?
Q3.
Is there a possibility of metastasis to other areas? (Note: A chest X-ray has shown no abnormalities; can we rule out lung metastasis?)

mó, 40~49 year old female. Ask Date: 2018/03/16

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is not possible to estimate cancer markers based on tumor size.
If it cannot be determined whether there is metastasis, we should first address the currently obvious targets and observe how the fetal protein responds.
X-rays may have some blind spots, or the tumor could be too small to be seen with the naked eye.
You should discuss your concerns with your clinical physician for clearer guidance.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2018/03/16

More Info

The situation you describe regarding your father's liver tumor and the fluctuating levels of alpha-fetoprotein (AFP) is complex and requires careful consideration. Let's address your questions one by one.

Q1: Can a 1.5 cm liver tumor cause AFP levels to exceed 400?
While AFP is a well-known tumor marker primarily associated with hepatocellular carcinoma (HCC), it is important to note that the level of AFP does not always correlate directly with the size of the tumor. A 1.5 cm tumor can indeed lead to elevated AFP levels, but reaching levels as high as 400 ng/mL is more commonly associated with larger tumors or more aggressive disease. In some cases, even small tumors can produce significant amounts of AFP, especially if they are of a certain histological type or if there is underlying liver disease, such as cirrhosis or chronic hepatitis. Therefore, while it is possible for a 1.5 cm tumor to cause such a spike in AFP, it is not typical, and further investigation is warranted to understand the underlying cause of the elevated AFP levels.

Q2: Is it possible that there are new issues in the peritoneum?
Given your father's history of abdominal surgery and the previous presence of tumors in the peritoneum, it is indeed possible that new issues could arise in that area. The presence of tumors in the peritoneum could indicate peritoneal carcinomatosis, which is a condition where cancer spreads to the peritoneal cavity. This could potentially contribute to elevated AFP levels as well. Regular imaging studies, such as CT or MRI scans, are crucial in monitoring for any new developments in the peritoneum. If there are concerns about new growths or changes in the peritoneal cavity, a biopsy may be necessary to determine the nature of these findings.

Q3: Could there be metastasis to other organs?
While your father's chest X-ray did not show any abnormalities, it is important to remember that imaging studies can sometimes miss small metastatic lesions, particularly in the lungs. If there is a suspicion of metastasis, further imaging studies, such as a CT scan of the chest or a PET scan, may be warranted to provide a more comprehensive evaluation. Additionally, the pattern of AFP elevation and the presence of any new symptoms should be closely monitored. If there are any clinical signs suggestive of metastasis, such as unexplained weight loss, new pain, or changes in appetite, these should be discussed with the healthcare provider promptly.

Conclusion
In summary, while a 1.5 cm liver tumor can potentially cause elevated AFP levels, the degree of elevation you mentioned is atypical and warrants further investigation. The possibility of new issues in the peritoneum and the risk of metastasis to other organs should also be considered, especially given your father's medical history. Continuous monitoring through imaging and regular consultations with healthcare professionals are essential in managing his condition effectively. It is crucial to maintain open communication with his medical team to address any concerns and to ensure that appropriate diagnostic measures are taken.

Similar Q&A

Is a Slightly Elevated AFP and a 0.6 cm Nodule Indicative of Liver Cancer?

During my last health check-up, my AFP level was elevated at 13, and an ultrasound revealed a 0.6 cm nodule. However, my liver function tests (AST and ALT) are within the normal range, and I do not have hepatitis B or C. Is my risk of liver cancer high? The doctor only mentioned ...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Risk factors for liver cancer include individuals with chronic hepatitis (such as hepatitis B, hepatitis C, and autoimmune liver diseases), a family history of liver cancer, cirrhosis, alcohol consumption, obesity with metabolic liver disease, and certain environmental factors su...

Managing Liver Tumor Treatment: Patient Guidance and Medication Options

My father has undergone multiple treatments for liver tumors, including several embolizations and radiofrequency ablations. During a follow-up appointment, his alpha-fetoprotein (AFP) level was still 21.9. When I asked the attending physician, they were unsure of the reason. I wo...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello, after multiple treatments for liver cancer, the AFP level remains high. It is recommended to compare the current AFP value with previous values. Common causes of elevated AFP include chronic hepatitis, liver cirrhosis, and liver cancer. Elevated AFP can still occur in case...

Understanding Elevated AFP Levels: Potential Causes and Next Steps

Hello, I underwent a health check on May 25th, where it was found that my alpha-fetoprotein (AFP) level was elevated at 19.3. All related liver function tests, including GOT, GPT, alkaline phosphatase, bilirubin, and albumin, were normal, and an abdominal ultrasound on the same d...

Dr. Chen Yunfang reply Oncology
Hello: If a CT scan does not reveal any abnormalities in the liver, an MRI scan is usually arranged for further evaluation. We will wait for the results of the examination. If any abnormalities are found, it will be up to the physician to determine the next steps. I cannot answer...

Understanding Elevated AFP Levels: Next Steps and Treatment Options

Hello Dr. Lin, I would like to ask about my recent health check-up at work where I found that my AFP level is 97.75. I then went to the hospital for further examination, where they checked my GOT, GPT, and performed an ultrasound, as well as tested for hepatitis B and C. The doct...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello, the high likelihood conditions associated with AFP include hepatitis, cirrhosis, liver cancer, pregnancy, and other less common cancers related to the embryo. For hepatitis, it is important to identify the cause, such as viral hepatitis, alcohol consumption, medications, a...