Task: Question Answering
Input (English): Question: A 54-year-old man is diagnosed with a left kidney tumor suggestive of renal cell carcinoma. In his preoperative analytical study, elevated levels of GPT, alkaline phosphatase and alpha-2-globulin and elongated prothrombin time are detected. The liver is enlarged diffusely, but without defects of hepatic infiltration. The most probable justification for these findings is due to: 
 Options:  <1> Liver metastases. <2> Intrahepatic tumor thrombosis. <3> Acute hepatitis <4> Presence of hepatotoxic substances produced by the tumor. <5> Hemochromatosis
Output (English): 4