Inappropriate erythropoietin level is found in all except

Ref Robbins 9/e p333 HCC may manifest with silent hepatomegaly, it is more often encountered in persons with symptomatic cirrhosis of the liver. In these persons, a rapid increase in liver size, sudden worsening of ascites, or the appearance of bloody ascites, fever, and pain call attention to the development of a tumor. There are no good serologic screening tests for hepatocellular carcinoma. The most commonly used marker is serum alpha-fetoprotein level, but it rises only with advanced tumors and only in 50% of patients. Fur- thermore, false-positive results are obtained in yolk-sac tumors, and many non-neoplastic conditions such as cir- rhosis, chronic hepatitis, normal pregnancy, and massive liver necrosis. Hence the test is neither specific nor sensi- tive. Radiologic screening of patients with cirrhosis at 6-month intervals, looking for dysplastic nodules or early, small hepatocellular BenignEdit There are several types of benign liver tumor. Hemangiomas: These are the most common type of benign liver tumor, found in up to 7% of autopsy specimens. They sta in blood vessels. Most of these tumors do not cause symptoms and do not need treatment. Some may bleed and need to be removed if it is mild to severe. A rare tumor is Infantile hemangioendothelioma. Hepatic adenomas: These benign epithelial liver tumors develop in the liver and are also an uncommon occurrence, found mainly in women using estrogens as contraceptives, or in cases of steroid abuse. They are, in most cases, located in the right hepatic lobe and are frequently seen as solitary. The size of adenomas range from 1 to 30 cm. Symptoms associated with hepatic adenomas are all associate with large lesions which can cause intense abdominal pain. Over the last few decades there has been an increase with occurrences of this specific type of adenoma. The prognosis for these tumors has still not been mastered. Some correlations have been made such as malignant transformation, spontaneous hemorrhage, and rupture. Focal nodular hyperplasia (FNH) is the second most common tumor of the liver. This tumor is the result of a congenital aeriovenous malformation hepatocyteresponse. This process is one in which all normal constituents of the liver are present, but the pattern by which they are presented is abnormal. Even though those conditions exist the liver still seems to perform in the normal range. Other types include nodular regenerative hyperplasia and hamaoma. carcinomas, is the current clinical frontier.