Chronic Alcoholic with Large Nodular Lump Abdomen

A male aged 57 years who is a chronic Alcoholic taking around 120-160 gram Ethanol per day since 30 years Chief Complaints Gradually enlarging Lump Abdomen Pain in Lump Anorexia and Wt loss Physical Examination A large nodular lump extending from Epigastrium to Umbilicus and RUQ. Tender Investigations TPCT Whole Abdomen with venous phase pics provided Diagnosis What can be the most imp differential for this mass and how shd he be approached

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Huge liver tumour probably intrahepatic cholangiocarcinoma Arterial phase picture would help know enhancement type Capsule retraction at few places Central necrosis is seen We can also see some cystic lesions in liver - probably mets or ADPKD -There is also a cyst in kidney. Send tumour markers AFP,CA-19-9,CEA Scopies Plan USG guided biopsy if not conclusive. Option of liver tumour resection or transplant not possible If liver function is good and Portal vein intact, TACE Chemotherapy

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Hepatoma.

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