A 55-year-old man with chronic HBV-related cirrhosis is found to have a 3 cm arterially enhancing hepatic lesion on contrast CT that shows washout in the portal venous phase. AFP is 450 ng/mL. The most likely diagnosis is:
- A Hepatic adenoma
- B Haemangioma
- C Hepatocellular carcinoma ✓
- D Focal nodular hyperplasia
Correct answer: C. Hepatocellular carcinoma
Explanation
In a cirrhotic patient, a hepatic lesion showing arterial hyperenhancement with portal venous phase washout on contrast CT is diagnostic of hepatocellular carcinoma (HCC) without biopsy, as defined by AASLD criteria. An AFP of 450 ng/mL further supports this diagnosis. Haemangiomas show peripheral nodular enhancement with progressive fill-in. Focal nodular hyperplasia has a central scar on MRI. Hepatic adenomas occur in young women on oral contraceptives without cirrhosis.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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