Fig. 1 |. Fibrolamellar carcinoma.

Tumour characteristics (left) and typical clinical features (right). Fibrolamellar carcinoma (FLC) presents, often with vague symptoms, in adolescents and young adults. It is associated neither with liver cirrhosis nor with other factors known to predispose to hepatocellular carcinoma. Primary FLC tumours often grow relatively slowly, but they are highly aggressive and invasive. The cure rate is very low. Common metastatic sites include local lymph nodes, lung and peritoneum. Less frequently observed locations include bone, ovary and intracranial¹⁶⁶. Diagnosis often occurs only after extensive tumour growth, due to non-specific symptoms and a lack of non-invasive biomarker assays. Image (top left) courtesy of M. Torbenson, Mayo Clinic, USA.