HCC

Fibrolamellar carcinoma of the liver

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Fibrolamellar Carcinoma Liver MCQ |

Fibrolamellar Carcinoma Liver MCQ – Young Female Liver Tumor

📘 Theme: Liver Tumors – Hepatobiliary Surgery (NEET SS / INI-CET High Yield)

Fibrolamellar Carcinoma MCQ

Which of the following statements regarding fibrolamellar carcinoma of the liver is correct?

A. Occurs in the setting of cirrhosis
B. Has worse survival than hepatocellular carcinoma
C. Can be followed up for long time
D. Seen in young females

Answer: D. Seen in young females

Explanation

Fibrolamellar carcinoma (FLC) is a rare variant of hepatocellular carcinoma that typically affects adolescents and young adults, often females, without underlying cirrhosis or chronic liver disease. Unlike conventional HCC, AFP is usually normal or only mildly elevated.

Histologically, it is characterized by large eosinophilic tumor cells separated by dense lamellar fibrosis.

Why other options are incorrect

  • Occurs in the setting of cirrhosis: False. FLC usually arises in non-cirrhotic livers.
  • Has worse survival than hepatocellular carcinoma: False. Fibrolamellar carcinoma generally has better survival than conventional HCC because patients are younger and liver function is preserved.
  • Can be followed up for long time: False. Surgical resection is the treatment of choice because the tumor has malignant potential.

High-yield teaching points

  • Young patient + liver mass + no cirrhosis = think fibrolamellar carcinoma.
  • AFP is often normal in fibrolamellar carcinoma.
  • Central scar may mimic focal nodular hyperplasia on imaging.
  • Best treatment is aggressive surgical resection.

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HCC Surveillance in High-Risk Patients – Clinical MCQ

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HCC Surveillance and Screening MCQ | NEET SS Surgery | MCQSurgery

Hepatocellular Carcinoma Surveillance – Clinical MCQ

High-Yield Liver MCQ for NEET SS, MCh and GI Surgery
LIVER • HEPATOCELLULAR CARCINOMA
Which of the following is true regarding surveillance for hepatocellular carcinoma (HCC)?
A. Serum alpha-fetoprotein (AFP) alone should be performed every 6 months
B. Abdominal ultrasound should be performed every 6 months
C. All candidates awaiting liver transplantation should undergo HCC surveillance every 3 months
D. Hepatic nodules larger than 2 cm should simply be followed up more frequently
✓ Correct Answer: B. Abdominal ultrasound should be performed every 6 months
Explanation

Surveillance for hepatocellular carcinoma is performed in patients at increased risk of developing HCC, particularly those with cirrhosis and selected patients with chronic hepatitis B infection.

Ultrasound-based surveillance at approximately 6-month intervals is the standard approach. Serum AFP may be used as an adjunct depending on the guideline and clinical setting, but AFP alone is not considered an adequate surveillance strategy.

Why are the other options wrong?

A. AFP alone every 6 months – Incorrect.
AFP has limited sensitivity and specificity. It should not be relied upon as the sole surveillance modality for HCC.

C. All transplant candidates every 3 months – Incorrect.
More frequent surveillance is not routinely required for every patient awaiting liver transplantation. The surveillance interval may vary according to individual clinical circumstances and the presence of known lesions.

D. Nodules larger than 2 cm should simply be followed more frequently – Incorrect.
A liver lesion larger than 2 cm requires appropriate diagnostic evaluation, usually with multiphasic contrast-enhanced imaging, rather than merely more frequent surveillance.

Teaching Point:

The key interval to remember for HCC surveillance is 6 months. Ultrasound is the cornerstone of surveillance, while AFP may be used as an additional tool depending on the clinical protocol.
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