Aims: To determine the clinical and histopathological features of a ca
se of a spontaneous regression of hepatocellular carcinoma (HCC). Case
details: HCC was found incidentally in a 73-year-old man during a lap
arotomy for evaluation of gastric retention, Despite no treatment bein
g given, he improved gradually with no sign of tumour as evidenced by
coeliac angiography 15 months later, as well as by explorative laparot
omy after another 2 years, The patient died 15 years after the primary
diagnosis of HCC, without known evidence of tumour recurrence, The pa
tient's clinical records were reviewed, and paraffin-embedded liver ti
ssue was re-evaluated, Both histological and immunohistochemical featu
res were compatible with the diagnosis of a well differentiated HCC, C
onceivable causes of the spontaneous regression of this and other repo
rted cases are discussed, but the phenomenon remains enigmatic. Conclu
sions: This case with a histologically proven HCC and a very long foll
ow-up time confirms that spontaneous regression does occur. Since the
case was found incidentally our report also implies that this may not
be as rare as reported.