**Question:** True about Fibrolamellar carcinoma of Liver is all, EXCEPT

A. It is a rare and aggressive form of liver cancer
B. It is typically diagnosed in children or young adults
C. It is associated with hepatitis B or C infection
D. It is highly responsive to chemotherapy

**Correct Answer:** D. It is highly responsive to chemotherapy

**Core Concept:** Fibrolamellar carcinoma of the liver is a rare primary liver malignancy that predominantly affects young adults. It is characterized by the formation of fibrous and lamellar structures within the liver tissue. Unlike other liver cancers, fibrolamellar carcinoma is not strongly associated with hepatitis B or C infection.

**Why the Correct Answer is Right:** Fibrolamellar carcinoma is typically diagnosed in individuals between the ages of 20 and 40, making option D ("It is highly responsive to chemotherapy") incorrect. Unlike conventional liver cancer, fibrolamellar carcinoma does not demonstrate a high level of response to chemotherapy. Although chemotherapy is often used as part of the treatment strategy, its effectiveness may not be as high as suggested by option D.

**Why Each Wrong Option is Incorrect:**

A. Fibrolamellar carcinoma is generally considered a rare and aggressive form of liver cancer, so option A is correct.

B. Although fibrolamellar carcinoma can occur in children, it predominantly affects young adults, not exclusively children. Therefore, option B is incorrect.

C. Unlike other liver cancers, fibrolamellar carcinoma is not strongly associated with hepatitis B or C infection. Thus, option C is correct as it highlights a distinguishing characteristic of fibrolamellar carcinoma.

**Clinical Pearl:** Fibrolamellar carcinoma is a distinct liver cancer subtype that often presents in young adults and has specific clinical features that differentiate it from conventional liver cancer. While chemotherapy may be a part of the management strategy, its efficacy may not be as high as suggested by option D. Understanding these differences between fibrolamellar carcinoma and other liver cancers is essential for accurate diagnosis and treatment planning.