Introduction Metastasis most common malignant hepatic tumor Hepatocellular carcinoma (hepatoma) is most common primary malignant hepatic tumor most common malignancy in the world due to vertical transmission of HBV endemic in SE Asia and Africa Associated with: HBV HCV ETOH Hemochromatosis Wilson's disease Presentation Symptoms weight loss jaundice weakness pain RUQ or epigastric constant dull Physical exam hepatomegaly palpable mass distension (ascites) Evaluation Labs increased alk phos increased bilirubin postive hepatitis B and C serology elevated AFP Ultrasound, CT Treatment Prevention: Hepatitis vaccination recommended in childhood fpr preventing HBV infection, cirrhosis, HCC, liver failure, and death. The vaccine is a recombinant DNA vaccine. Surgical resection