Hepatocellular carcinoma is the most common primary malignant hepatic neoplasm. It usually develops in the setting of chronic liver disease such as cirrhosis, hemochromatosis, and glycogen storage diseases. Predisposing factors for eastern and African cultures are infectious hepatitis and exposure to aflotoxin B. In the western hemisphere, cirrhosis is due to alcohol abuse, toxin exposure and chronic hepatitis. Clinical features include pain, mass, weight loss, and elevation of alpha-fetoprotein.