<prompt> Which of the following is NOT true about carcinoma of liver?AFP increased in 70 of casesResection possible in few cases onlyUSG guided biopsy is good for diagnosisAflatoxin and thorotrast are not risk factor  <response>: Thorotrast colloidal thorium dioxide is an angiographic medium that was used in 1930s. It emits high levels of long- standing radiation. It has been associated with: Hepatic fibrosis Hepatocellular carcinoma Cholangiosarcoma Angiosarcoma Aflatoxin has been mentioned as the most potent ubiquitous natural chemical carcinogen. It is a product of the Aspergillus fungus, called aflatoxin B1. This mould and aflatoxin products can be found in grains stored in hot, humid places, where peanuts and rice are stored in non refrigerated conditions. Aflatoxin contamination of foodstuffs correlates with incidence rates in Africa and to some extent in China. Option 1 AFP levels 500 microgramliter are found in about 70 to 80 of cases. Lower levels may be found in patients with large metastasis from gastric or colonic tumors and in some patients with acute or chronic hepatitis. Option 3 Percutaneous liver biopsy under USG or CT guidance can be diagnostic, but there is a risk of hemorrhage as these tumors are highly vascular. Option 2 Because of multicentricity, bilobar involvement, poal vein invasion, and lymphatic metastasis only 15-20 of hepatocellular carcinoma are resectable. Ref: Sabiston 18e, Page 1502; Harrison 17e, Page 582. 