The most unlikely clinical feature of Hepatocellular carcinoma is -
- Raised a-fetoprotein levels.
- Raised alkaline phosphatase
- “Jaundice is rare, unless significant deterioration of liver function or obstruction of bile ducts occurs. Serum elevations of alkaline phosphates and alpha fetoprotein are common” — Harrison 16/e (not mentioned in 17th edition)
- HCC tends to present at late stages because it occurs in patients with underlying cirrhosis and the symptoms and signs may suggest progression of the underlying disease.
- Symptoms at this advanced stage are
- vague rt upper quadrant abd. pain
- nonspecific sym. of advanced malignancy (i.e. anorexia, wt. loss, lethargy)
- Hepatomegaly or a mass is palpable in many patients.
- Serum elevation of alkaline phosphates and a feto-protein are common.
- Most common symptom- abdominal pain.
- Most common physical sign- hepatomegaly