Primary hepatic YST is usually not considered in the differential diagnosis of liver tumors because of its rarity, and is usually misdiagnosed as HCC at presentation in adults.[8,10,11,14,15,17] For malignant liver tumors with highly elevated AFP levels in adults, HCC is always the first suspected diagnosis, especially in patients with underlying chronic liver disease or liver cirrhosis. The gene discussed is AFP; the disease is liver cancer.