38 year old man Babbu, a chronic alcoholic, presents with pain in abdomen. On examination his liver is enlarged and serum a fetoprotein is elevated. The most likely diagnosis is -

Ans. is 'a' i.e., Hepatocellular carcinoma o Increase in a feta protein is associated with hepatocellular carcinoma and chronic alcoholism is a well known and common predisposing factor. Clinical Feature o In most cases hepatocellular carcinoma presents as an ill defined upper abdominal pain, malaise, fatigue and weakness and sometimes awareness of an abdominal mass or abdominal fullness. o On palpation, the enlarged liver may be felt as a Unifocal usually large mass Multifocal widely distributed nodules of variable size. Diffuse infiltrative cancer.