<prompt> A chronic alcoholic has an elevated serum alpha fetoprotein levels. Which of the following neoplasms is most likely -Prostatic adenocarcinomaMultiple myelomaHepatocellular carcinomaGlioblastoma multiforme  <response>: Elevated levels of serum α-fetoprotein are found in 50 to 75 of patients with HCC.False-positive results are encountered with yolk-sac tumors and many non-neoplastic conditions, including cirrhosis, massive liver necrosis, chronic hepatitis, normal pregnancy, fetal distress or death, and fetal neural tube defects such as anencephaly and spina bifida.ConceptThe staining for Glypican-3 is used to distinguish early hepatocellular carcinoma from a dysplastic nodule. Other tests cannot be used because the levels of serum α-fetoprotein are inconclusive in this condition. 