Hardened Liver Due to Fibrolamellar Hepatocellular Carcinoma

A 48-year-old woman with no past medical history presented to the primary care clinic with right-sided abdominal pain, fatigue, and a 20-lb weight loss over 3 months. She described a short period of heavy alcohol use (a bottle of wine per day for 3 years), although she had been abstinent for 1 year before presentation. She has 2 daughters with Alagille syndrome. She had no other risk factors for liver disease. Initial evaluation revealed abnormal liver biochemical tests (alanine aminotransferase: 130 U/L, aspartate aminotransferase: 107 U/L, alkaline phosphatase: 622 U/L, total bilirubin: 0.9 mg/dL).
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Image of the Month Source Type: research