Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions

Douglas G. Adler, MD

Question 35: A 55-Year-Old Man With Cirrhosis Is Found To Have A 1.5-Cm Liver Lesion And An Elevated Alpha-Fetoprotein. Is A Biopsy Or Other Testing Required To Confirm A Diagnosis Of Hepatocellular Carcinoma? What Other Evaluation Is Warranted? (continued)

Fredric D. Gordon, MD

Hepatocellular carcinoma is the sixth most common cancer and the third leading cause of cancer deaths worldwide. It is estimated that, in the United States, the number of cases of hepatocellular carcinoma will increase by 81% over the current baseline of 13,000 cases per year by the year 2020. Most of this increase is attributable to the rising prevalence of hepatitis C cirrhosis. The risk factors for the development of hepatocellular carcinoma are listed in Table 35-1.1 The patient described in this question provides some interesting diagnostic considerations. He is certainly in a high-risk…