Outline the initial approach to evaluating a patient with a suspected liver mass.

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When a liver mass is suspected, start with a broad, noninvasive assessment that integrates risk factors and basic liver evaluation. Look for predisposing factors like cirrhosis, chronic hepatitis B or C, and heavy alcohol use, and perform a thorough physical exam to assess for signs of liver disease. Obtain liver-focused labs to gauge injury and synthetic function and check an AFP level to help raise suspicion for hepatocellular carcinoma in the right clinical context. Imaging is then used to detect and characterize the lesion, with ultrasound typically serving as the first-line, noninvasive modality to confirm the presence of a mass and assess its characteristics. If a lesion is found, advance to multiphasic cross-sectional imaging with contrast (CT or MRI) to evaluate vascular patterns and washout, which are crucial for distinguishing hepatocellular carcinoma from benign lesions and other tumors. Referral to hepatology is appropriate when there is suspicion for HCC or when the case is complex. Biopsy is reserved for situations where imaging cannot definitively distinguish malignant from benign disease or when histology would change management; it carries risks such as bleeding and potential tumor seeding, so it is not the initial step. Other options skip essential noninvasive evaluation and imaging, leading to delays or misdiagnosis.