1. Typical Case of HCC

2. History
54 y/o M with HCV diagnosed 30 yrs ago presented to PCP with 3 week history of constant RUQ and periumbilical pain
PMH : HCV-NR to IFN/Ribavirin , DM/HTN 5 yrs
PSH: Neck Surgery 1980, Hand surgery 1970
Social Hx: Quit alcohol in 1991,no smoking
Medications: Norvasc,Prinivil,Glucophage, Percocet

3. PE Alert, oriented times three Sclera nonicteric
Liver 6 cm below costal edge, tender to palpation, spleen 2 cm below costal edge, no ascites
No edema, no clubbing
Spider nevi
No evidence of asterixis

4. Labs/Radiology Albumin 3.4 gr/dl T. Bil 1.5 mg/dl AP 221 U/L
SGOT 194 U/L
SGPT U/L
PLT 141 K
PT/INR 1.3
AFP >520
CT Cirrhosis
MRI Cirrhosis

5. Laparoscopy

6. Liver Biopsy

7. Liver Biopsy