Question

What is NOT true about fibrolamellar cancer of the liver?

• A. Not more common in males
• B. Better prognosis
• C. AFP is raised over 1000
• D. Seen in a younger age group

Hint:

Fibrolamellar HCC is the young, non-cirrhotic liver cancer with a near-normal AFP, unlike classic HCC.

Answer 1

The Correct Option is C

Fibrolamellar hepatocellular carcinoma is a distinct subtype of liver cancer that behaves quite differently from the usual (classic) hepatocellular carcinoma, and the question wants the one statement below that does not match its known features.

1. Not more in males: True. While classic HCC has a strong male preference, fibrolamellar HCC has close to an equal sex distribution.
2. Better prognosis: True. Because it usually arises in an otherwise healthy, non-cirrhotic liver and is often found before it has spread widely, it can be resected more often and carries a better outlook than classic HCC.
3. AFP is raised over 1000: False. This tumor is known for a normal or only mildly raised AFP; a very high AFP over 1000 points to classic HCC in a cirrhotic liver instead.
4. Seen in a younger age group: True. It is the classic liver cancer of children, teenagers, and young adults without cirrhosis, unlike classic HCC which appears in older patients with chronic liver disease.

Since three of the four statements match the known features of fibrolamellar HCC, the odd one out, and the correct answer, is the claim about a markedly raised AFP.

Let's summarize:

• Fibrolamellar HCC: young patients, no cirrhosis, near-normal AFP, better prognosis, equal sex distribution.
• Classic HCC: older patients, cirrhotic liver, often high AFP, worse prognosis, more common in males.

So the false statement, and the answer, is that AFP is raised over 1000.