A 26-year-old non-cirrhotic woman is found to have a 9 cm hepatic mass. Biopsy shows large polygonal cells with abundant eosinophilic cytoplasm arranged in thick lamellar fibrous bands. AFP is normal. Which statement about this tumor is correct?
- A It carries a worse prognosis than conventional hepatocellular carcinoma at the same stage
- B It is strongly associated with hepatitis B infection
- C It occurs predominantly in young patients without underlying cirrhosis and may be amenable to complete surgical resection with prolonged survival ✓
- D Serum CA 19-9 is characteristically markedly elevated
Correct answer: C. It occurs predominantly in young patients without underlying cirrhosis and may be amenable to complete surgical resection with prolonged survival
Explanation
The histology describes fibrolamellar hepatocellular carcinoma, which arises in young adults with normal livers, shows normal or mildly raised AFP, and, because patients lack cirrhosis, often permits complete resection with survival far better than conventional HCC of similar size. It has no association with viral hepatitis, killing option B, and CA 19-9 is not its marker.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.