{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:25:45Z","timestamp":1787120745798,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Hepatitis B induced hepatocellular carcinoma (HCC) is an important cause of morbidity and mortality in sub\u2010Saharan Africa and particularly in Zambia presenting at a younger age compared to other regions globally and with poorer prognosis. Early diagnosis remains a challenge in low resource settings where advanced imaging, supportive serological testing, and histopathology services are limited, resulting in most cases of HCC being diagnosed late, usually clinically with more advanced disease and with limited treatment options. A 32\u2010year\u2010old male with chronic hepatitis B infection, anemic, and a 12\u2010year history of excessive alcohol use was referred from a district hospital for evaluation of HCC based on a positive hepatitis B surface antigen, an elevated alpha fetoprotein, and an abdominal ultrasound showing multiple hepatic masses. The atypical enhancement pattern of the steatotic variant of HCC in this patient failed to meet standard non\u2010invasive diagnostic criteria, precluding oncology referral under local protocols and necessitating tissue confirmation. Ultrasound\u2010guided biopsy was however definitive in the diagnosis. Significant challenges exist in the evaluation and confirmation of HCC in Zambia, contributing to delay in commencing the available treatment options. Additionally, unhealthy consumption of alcohol in chronic hepatitis B necessitates vigilant surveillance to detect hepatocellular carcinoma.<\/jats:p>","DOI":"10.1002\/ccr3.73056","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:43:48Z","timestamp":1782899028000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges in the Diagnosis of Hepatocellular Carcinoma in a 32\u2010Year\u2010Old Male With Hepatitis\n                    <scp>B<\/scp>\n                    and Alcohol Use"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8372-1131","authenticated-orcid":false,"given":"E.","family":"Syabbalo","sequence":"first","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Mwanza","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Kaoma","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"},{"name":"The University of Zambia School of Medicine  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Shumbwa","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"},{"name":"The University of Zambia School of Medicine  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chibuta","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Mulopwe","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Mupeta","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mubbunu","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"},{"name":"The University of Zambia School of Medicine  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sinkala","sequence":"additional","affiliation":[{"name":"The University Teaching Hospital  Lusaka Zambia"},{"name":"The University of Zambia School of Medicine  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.017"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60383-9"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-08426-y"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i15.2651"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2018-000260"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.289"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.08.028"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29913"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqad113"},{"key":"e_1_2_14_12_1","unstructured":"\u201cGlobal Cancer Observatory: Cancer Today \u201daccessed June 8 2025 https:\/\/gco.iarc.who.int\/today."},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181f31caa"},{"issue":"6","key":"e_1_2_14_14_1","first-page":"146","article-title":"Primary Carcinoma of the Liver in Zambia","volume":"10","author":"Naik K. 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