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Stage I Seminoma — RACP Adult Medicine MCQ

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HardMedical OncologyStage I SeminomaRACP Adult Medicine

A person with compensated hepatitis B cirrhosis has an ultrasound showing a new 18 mm lesion. AFP is normal. Which next step is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Obtain liver-protocol multiphasic CT or contrast MRI

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as D · D = shown as E

B is correct. A new lesion at least 10 mm on surveillance requires diagnostic multiphasic CT or MRI; normal AFP does not exclude HCC. A delays diagnosis. C biopsy is reserved for indeterminate imaging or selected contexts because imaging can be diagnostic and biopsy has risks. D requires staging and confirmation. E compensated cirrhosis still carries HCC risk.

Reference: Medical Journal of Australia, Australian hepatocellular-carcinoma consensus recommendations: https://www.mja.com.au/journal/2021/214/10/australian-recommendations-management-hepatocellular-carcinoma-consensus