A 21-year-old man presented with a 2-month history of weight loss, night sweats and early satiety. Physical exam revealed hepatomegaly, shown on this caudal view of the upper abdomen.
The CT scan shows a 20X15cm right lobe mass. There was no evidence of extrahepatic tumor on the abdominal CT, and CT of the chest and bone scan were both normal. Core needle biopsy of the mass showed non-fibrolamellar hepatocellular carcinoma. Upper endoscopy and colonoscopy were normal. Bilirubin was 0.7 and liver enzymes were normal. Hepatitis serologies were normal. Alphafetoprotein was over 230,000.
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