A 53-Year-Old Man Comes to the Physician with Progressively Worsening

question 613

Multiple Choice

A 53-year-old man comes to the physician with progressively worsening anorexia and abdominal discomfort.  He has lost 14 kg (31 lb) since the onset of his symptoms about 4 months ago.  Physical examination demonstrates nontender hepatomegaly.  Laboratory studies show an elevated serum alkaline phosphatase level and a marginally elevated alanine aminotransferase level.  A CT scan of the abdomen with oral and intravenous contrast is shown below. Which of the following is the most likely diagnosis?

• A)Hepatic adenoma
• B)Hepatic angiosarcoma
• C)Hepatoblastoma
• D)Hepatocellular carcinoma
• E)Intrahepatic cholangiocarcinoma
• F)Metastatic liver disease

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Definitions:

Psychoanalytic Model

A psychological theory that emphasizes unconscious processes and childhood experiences in shaping personality and behavior.

Unconscious Conflicts

Internal struggles stemming from unresolved issues or desires that operate outside of conscious awareness, often a focal point in psychoanalytic theory.

Psychological Disorders

Mental disorders characterized by patterns of behavior or thoughts that are significantly distressing or impairing in daily functioning.

World Health Organization

A specialized agency of the United Nations responsible for international public health.