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Gastroenterology


Answer 1
  1. Obtain a computed tomography (CT) scan. If the diagnosis of hepatocellular carcinoma (HCC) is uncertain, contrast-enhanced CT scanning is often a useful test to perform. HCC has a characteristic hypervascular/enhancing pattern that is often seen on contrast-enhanced CT scans. CT also can exclude the diagnosis of extrahepatic metastases. Carbohydrate antigen 19-9 is not usually elevated in patients with HCC. Either surgical resection of the tumor alone or hepatectomy would be too aggressive a measure until the presence of cancer has been more definitively confirmed. Additionally, transplantation may be the preferred treatment when HCC is confirmed. Repeating the test for alpha-fetoprotein (AFP) in 3 to 6 months might not provide any additional information, because as many as 30% of hepatocellular cancers do not produce AFP.

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