Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 48: What Should I Recommend For My Patient With Cirrhosis Who Was Recently Found To Have A New 2-Centimeter Liver Mass By Ultrasound Screening? (continued)

Lawrence Chang, MD; R. Todd Stravitz, MD

In a patient with cirrhosis, the differential diagnosis of a new liver mass found on ultrasound (US) surveillance includes malignant and nonmalignant macronodules. Hepatocellular carcinoma (HCC) is obviously the primary concern. Major risk factors for developing HCC in patients with cirrhosis include older age, male sex, a family history of HCC, coinfection with more than one hepatotropic virus (hepatitis B and C), and coinfection with human immunodeficiency virus (HIV). The risk of developing HCC in a patient with cirrhosis varies with the etiology of underlying liver disease, with highest…