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Abstract
Hepatocellular carcinoma is one of the major killers worldwide. It consists 90% of primary liver cancers. Highest incidence is among black Africans and Asians. However, Egypt also shares this problem. Cirrhosis, hepatitis B virus and hepatitis C viral infection, alcoholism, aflatoxins and sex hormone therapy are the most common risk factors of hepatocellular carcinoma. Pathologically, it takes one of three forms: nodular, massive or diffuse by gross inspection and shows one of three types of growth: expanding, spreading or multifocal type. Microscopically it is divided to well differentiated, moderately differentiated and poor differentiated forms. HCC can metastasize intrahepatic or extrahepatic. Symptoms are usually unclear, in form of right upper quadrant abdominal pain accompanied by abdominal distention, anorexia or early satiety with weight loss. Other symptoms due to metastasis in form of jaundice, hematemesis, metastatic bone pain, or an acute intraperitoneal hemorrhage. Physical findings include hepatomegaly, splenomegaly, jaundice, muscle wasting, fever or dilated abdominal veins.