Fulminant hepatic failure as the initial manifestation of primary hepatocellular carcinoma

A 20-year-old male, with no history of chronic liver disease, presented wit h fulminant hepatic failure. The cause was not established until post morte m when it was found that he had a primary hepatocellular carcinoma in a non cirrhotic liver. To our knowledge, this is the third report of hepatocellul ar carcinoma presenting in this manner. Although rare, primary malignancies of the liver should be considered in the differential diagnosis of fulmina nt hepatic failure, especially when other more common causes are excluded. (C) 2000 Lippincott Williams & Wilkins.