HighlightsHepatocellular carcinoma (HCC) is an extremely rare finding in young adult.Giant HCCs are larger than 10 cm in diameter and mostly develop in non-cirrhotic livers.Pigmented hepatocellular adenoma (HCA) with beta-catenin activation have an increased risk for malignant transformation.Surgical resection is the only curative treatment with best long-term outcome.Molecular classification of HCAs is a useful tool for risk assessment of malignant transformation.

Hepatocellular carcinoma is among the leading causes of cancer-related mortality. Due to the numerous surgical and non-surgical therapeutic options, the treatment strategy requires an optimal selection of patients based on tumor stage and liver functional reserve. A potentially curative surgical resection or liver transplantation is only recommended for patients with early stage disease. In this chapter, we overview the current topics and perspectives in the surgical management of hepatocellular carcinoma by disease stage with a special focus on new surgical techniques and expanding range of indications outside of the accepted Barcelona Clinic Liver Cancer algorithm.

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