AFP and hepatocellular carcinoma: As a final takeaway, important indicators for the presence of cHCC-CCs include (a) synchronous elevation of serum tumor AFP and CA19-9, (b) a mixed or atypical enhancement pattern on imaging, and (c) discordance between the imaging findings and serum tumor markers (e.g., a HCC imaging pattern with elevated serum CA19-9 or an ICC pattern with elevated serum AFP) [18,39,40,45].