AFP and hepatocellular carcinoma: 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.