All are features of hepatocellular carcinoma, except?

Ans. is 'a' i.e., Not common in Asians Hepatocellular carcinoma Primary hepatocellular carcinoma is especially prevalent in regions of Asia and Africa. The largest number of cases are found in Asia followed by Africa. o More than 85% of cases of HCC occurs in countries with high rates of chronic HBV infection. In these regions HBV carrier state begins in infancy following veical transmission of virus from infected mothers, conferring a 200 fold increased risk for HCC by adulthood. Other major etiological associations for liver carcinoma are ? o Chronic alcoholism o Tyrosinemia o Food contaminants (primarily aflatoxins derived from Aspergillus flavus) o Hereditary hemochromatosis Clinical features of hepatocellular carcinoma ? o The clinical manifestations of hepatocellular carcinoma are not characteristic of hepatocellular carcinoma. The symptoms of hepatocellular carcinoma are often masked by symptoms of chronic hepatitis or cirrhosis. o In most cases hepatocellular carcinoma presents as an ill defined upper abdominal pain and an abdominal mass. o Elevated level of serum alphafetoproteins are seen in 50 - 75% cases. o Hepatocellular carcinomas have a strong propensity for invasion of vascular channels. Extensive intrahepatic metastasis occurs and the tumour occasionally invades the poal vein or inferior venacava. o Unresected hepatocellular carcinoma has a very poor prognosis. Patients rarely survive beyond 4 months after the diagnosis. The 5 year survival rate after curative resection is 35% to 50%. o The fibrolamellar variant of the HCC is associated with a more ourable prognosis. It arises in otherwise healthy young adults and may be discovered while still amenable to surgical resection.