This topic was recently reviewed in the American Journal of Medicine. Cirrhosis of any cause is the principal risk factor, particularly related to hepatitis B and C infections, chronic alcohol abuse and non-alcoholic steatohepatitis in the settings of obesity and type 2 diabetes.
Associated paraneoplastic syndromes may occur due to the elaboration of erythropoietin, insulin-like growth factor and parathyroid related protein.
Screening for HCC is controversial although some organizations recommend ultrasound every 6 months in high risk patients.
Diagnostic and treatment strategies are presented.