 For primary liver tumors alpha-fetoprotein, abdominal ultrasound and CT scan of the abdomen are the suggested tests for the screening in patients that are at higher risk of developing this complication. Measurement of serum alpha-fetoprotein AFP may be helpful in the diagnosis and management of HCC. AFP is elevated above 20 ngMl in more than 70 of patients with HCC. However, AFP elevations from 10-500 ngMl and even occasionally to 1000 ngml may be seen in patients with a high degree of inflammatory activity such as with chronic viral hepatitis, who do not have HCC 3. The sensitivity, specificity, and positive predictive value of AFP in 3 well performed screening studies for HCC ranged from 39-64, 76-91, and 9-32, respectively 4. Imaging studies play a key role in the diagnosis of HCC since a significant number of cases are missed by AFP. CT scan and magnetic resonance imaging are commonly used tests. 