📋 HISTORY
🔹 Middle-aged male
🔹 Progressive abdominal distension
🔹 Dull aching right upper quadrant discomfort
🔹 Anorexia and weight loss
🔹 No significant past medical history of liver disease
――――――――――――――
🩺 EXAMINATION
🔹 Hepatomegaly — firm to hard in consistency
🔹 Left lobe prominently enlarged
🔹 Mass moves with respiration
🔹 Ascites present — shifting dullness positive
🔹 No splenomegaly
🔹 No signs of chronic liver disease
――――――――――――――
🔬 INVESTIGATIONS
🔹 LFTs — raised bilirubin, low albumin
🔹 AFP — tumour marker
🔹 HBsAg / Anti-HCV — hepatitis serology
🔹 Ultrasound abdomen — liver lesion characterisation
🔹 CT abdomen (triphasic) — arterial enhancement
🔹 Ascitic fluid tap — cytology, SAAG
🔹 Coagulation profile
――――――――――――――
❓ QUESTION
What is the most likely diagnosis?
🔹 Middle-aged male
🔹 Progressive abdominal distension
🔹 Dull aching right upper quadrant discomfort
🔹 Anorexia and weight loss
🔹 No significant past medical history of liver disease
――――――――――――――
🩺 EXAMINATION
🔹 Hepatomegaly — firm to hard in consistency
🔹 Left lobe prominently enlarged
🔹 Mass moves with respiration
🔹 Ascites present — shifting dullness positive
🔹 No splenomegaly
🔹 No signs of chronic liver disease
――――――――――――――
🔬 INVESTIGATIONS
🔹 LFTs — raised bilirubin, low albumin
🔹 AFP — tumour marker
🔹 HBsAg / Anti-HCV — hepatitis serology
🔹 Ultrasound abdomen — liver lesion characterisation
🔹 CT abdomen (triphasic) — arterial enhancement
🔹 Ascitic fluid tap — cytology, SAAG
🔹 Coagulation profile
――――――――――――――
❓ QUESTION
What is the most likely diagnosis?
🅰️ Chronic liver disease with portal hypertension
🅱️ Hepatocellular carcinoma (HCC) with peritoneal metastasis
🅲️ Congestive hepatomegaly
🅳️ Hepatic abscess
🅴️ Metastatic liver disease only (without primary)
https://www.effectivecpmnetwork.com/p6x5cixrpy?key=0e3ba72754512fdd23ee8b77a5e394ed
❓ FAQ: Hepatocellular Carcinoma (HCC)
1. What is the most common risk factor for HCC?
Chronic liver disease, especially cirrhosis from Hepatitis B or C infection.
2. What tumour marker is used for HCC?
Alpha-fetoprotein (AFP) is the key serum marker, though it can be normal in some cases.
3. What is the characteristic imaging finding?
Arterial phase enhancement with venous phase washout on triphasic CT or MRI.
4. How does HCC commonly spread?
Local invasion into the portal vein, and metastasis to lungs, bones, and peritoneum.
5. What are treatment options?
Surgical resection, liver transplantation, ablation, TACE, or systemic therapy depending on stage and liver function.
1. What is the most common risk factor for HCC?
Chronic liver disease, especially cirrhosis from Hepatitis B or C infection.
2. What tumour marker is used for HCC?
Alpha-fetoprotein (AFP) is the key serum marker, though it can be normal in some cases.
3. What is the characteristic imaging finding?
Arterial phase enhancement with venous phase washout on triphasic CT or MRI.
4. How does HCC commonly spread?
Local invasion into the portal vein, and metastasis to lungs, bones, and peritoneum.
5. What are treatment options?
Surgical resection, liver transplantation, ablation, TACE, or systemic therapy depending on stage and liver function.
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Hepatology