Clinical Gastroenterology and Hepatology
Volume 4, Issue 1 , Pages 29-35, January 2006

Hepatocellular Carcinoma: Patients With Increasing Alpha-Fetoprotein But No Mass on Ultrasound

  • Josep M. Llovet

      Affiliations

    • Barcelona-Clinic Liver Cancer (BCLC) Group, Liver Unit, Digestive Disease Institute, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Catalonia, Spain
    • Division of Liver Diseases and Recanati Miller Transplantation Institute, Mount Sinai School of Medicine, New York, New York
    • Corresponding Author InformationAddress requests for reprints to: Josep M. Llovet, MD, Division of Liver Diseases, RM Transplantation Institute, Mount Sinai School of Medicine, 1425 Madison Avenue, 11F-70 Box 1104, New York, New York 10029; fax: (212) 241-2138.

published online 20 December 2005.

A 63-year-old man with hepatitis C virus–induced cirrhosis is referred to the clinic for evaluation of an increase in the level of alpha-fetoprotein (AFP) to 400 ng/mL, which was detected in a blood test performed by the primary care physician. The patient is active at work and asymptomatic. He has compensated cirrhosis and well-preserved liver function, with a serum albumin level of 38 g/L, a serum bilirubin level of 1.6 mg/dL, and a prothrombin time of 1.2 international normalized ratio. Physical examination shows a liver span of 4 cm and splenomegaly without ascites. The ultrasound examination shows hepatomegaly without any liver mass, preserved portal blood flow, and splenomegaly.

Abbreviations used in this paper:  AFP, alpha-fetoprotein , AFP-L3, lens culinaris agglutinin-reactive AFP , CT, computed tomography , EASL, European Association for the Study of Liver Diseases , HBV, hepatitis B virus , HCC, hepatocellular carcinoma , HCV, hepatitis C virus , MRI, magnetic resonance imaging , US, ultrasonography

 

 J. M. Llovet, Professor of Research–Institut Catala de Recerca Avançada (ICREA), is supported by the ICREA and the Instituto de Salud Carlos III (Fondo de Investigaciones Sanitarias 2002–2005, PI02/0596).

PII: S1542-3565(05)00864-5

Clinical Gastroenterology and Hepatology
Volume 4, Issue 1 , Pages 29-35, January 2006