AFP and hepatocellular carcinoma: Considering the challenges in the differential diagnosis between FNH-like lesions and HCC, specific diagnosis requires extensive clinical, laboratory and imaging work-up, including follow-up every 6 months if liver lesions have features of FNH-like lesions and alpha 1-fetoprotein levels are low, or liver biopsy if imaging features are atypical, if significant changes occur over time or if serum alpha 1-fetoprotein becomes elevated [49].