Prolonged survival without treatment in a patient with primary hepatocellular carcinoma

The proportion of primary hepatocellular carcinomas which are technically operable with hope of cure is small. Recommended therapy ranges from aggressive therapy to a nihilistic approach. There is little data available on the natural history of untreated tumours and we report such a case. A review of the literature regarding survival with primary hepatocellular carcinoma shows that the prognosis of patients with this tumour may vary considerably. Such variability has important implications for those involved in the design and interpretation of trials of treatment for hepatocellular cancer.