Blood chemistry tests showed a substantial elevation of α-fetoprotein values (1500 mg/ml), and slight increases of bilirubin (1.21 mg/ml), of γ-GT (116 U/L) and of GOT (76 U/L); the absence of encephalopathy and ascites, and the normality of coagulation parameters and of albumin led to classify the patient into the functional class Child-Pugh A. The echo-guided liver biopsy and the subsequent histo-pathological assessment definitely confirmed the diagnosis of HCC. The gene discussed is ALB; the disease is Encephalopathy.