Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a known diagnosis of massive hepatocellular carcinoma (HCC >10cm). Symptoms include progressive right upper quadrant (RUQ) pain, early satiety, unintentional weight loss, and fatigue. No history of hematemesis, melena, or encephalopathy. Current performance status (ECOG) is [Score]. Underlying liver disease etiology: [Hepatitis B/C/Alcohol/NASH].
Clinical Examination Findings
General: Cachectic appearance, scleral icterus present/absent. Abdomen: Significant hepatomegaly with a palpable, firm, irregular mass extending [X] cm below the right costal margin. Tenderness to palpation in RUQ. Ascites present/absent (fluid wave/shifting dullness). Stigmata of chronic liver disease: spider angiomata, palmar erythema, and caput medusae noted/absent.
Treatment Protocol
Management plan for massive HCC (>10cm): Multidisciplinary tumor board review completed. Due to tumor size and potential for vascular invasion/portal hypertension, treatment options include [TACE / Systemic therapy (e.g., Atezolizumab/Bevacizumab) / Palliative care]. Monitoring of liver function tests (LFTs), AFP levels, and serial cross-sectional imaging (CT/MRI) every [X] weeks. Pain management initiated.