This is a 27-year-old male patient, also a native of Senegal and with no previous history of interest, who consulted for vomiting and abdominal pain. The patient reported asthenia and anorexia of one month's duration, with diffuse abdominal discomfort from the onset. In view of the progression of the symptoms and the appearance of vomiting, he went to the emergency department. Physical examination showed an acceptable general state of health, with only a great pain on palpation in the epigastrium and right hypochondrium, with palpation of an area of impaction compatible with a mass at this level. There were no signs of peritoneal irritation, although there was voluntary defence. Laboratory tests showed moderate hypertransaminasemia and mild coagulopathy.
Ultrasonography revealed the presence of a large hepatic mass (approximately 12 cm in diameter) with numerous satellite nodules. MRI confirmed the hypervascular nature of these lesions. Finally, viral serology revealed chronic HBV infection and the alpha-fetoprotein was 12,687 ng/ml, so the patient was diagnosed with giant HCC with satellites and HBV infection. Symptomatic palliative treatment was started and he died a few months later.