Hepatocellular Carcinoma

A 58-year-old man from rural India presents with a 3-month history of right upper quadrant pain and progressive abdominal distension. He has a 20-year history of hepatitis B (HBsAg positive) and drinks alcohol socially. On examination, he is icteric, has hepatomegaly with a hard, nodular surface, and ascites. Serum AFP is 1200 ng/mL (normal <20 ng/mL). Abdominal ultrasound shows a 4 cm heterogeneous mass in the right lobe with features suggestive of arterial hyperenhancement. What is the most likely diagnosis?

A 58-year-old man with cirrhosis (Child-Pugh B) and a 3.5 cm solitary hepatocellular carcinoma in the right lobe, without vascular invasion or extrahepatic metastases, presents for treatment planning. Which is the drug of choice for systemic therapy if he is not a candidate for curative resection or transplantation?

A 58-year-old man with a 15-year history of hepatitis B infection presents with a solitary liver mass. Imaging and biopsy confirm hepatocellular carcinoma. Which of the following is the most common aetiological factor for HCC in this patient?

A 58-year-old man with cirrhosis secondary to chronic hepatitis B presents with a 3 cm solitary nodule in the liver on imaging. Regarding the diagnostic criteria and pathological features of hepatocellular carcinoma (HCC), all of the following are true EXCEPT:

A 62-year-old woman with HCV-related cirrhosis (Child-Pugh A5) undergoes screening ultrasound which shows a 2.2 cm hypoechoic nodule in segment 7. Contrast-enhanced CT shows arterial phase enhancement but no definite washout in the portal venous phase. AFP is 45 ng/mL. What is the most appropriate next step?