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Cholestatic jaundice' (~h~j i s ' a we1 1 known and presumably-benign complication o f proionged PN. We now r e p o r t a preterm-infant i n whom f a t a l hepatocellular carcinoma (CA) occurred as a consequence o f b i l i a r y c i r r h o s i s secondary t o prolonged PN and PNassociated ChJ. The p a t i e n t was a 900 gram, 27-week gestation i n f a n t . Recurrent episodes o f necrotizing enterocol i t i s led t o small bowel resection and r e s u l t a n t short gut syndrome, necessit a t i n g PN f o r a t o t a l o f 395 days. During t h i s time progressive 1 i v e r dysfunction developed, w i t h marked conjugated hyperbil irubinemia (maximum 11.2 mg/dl), and increased transaminase levels. L i v e r biopsy a f t e r 112 days o f PN revealed p e r i p o r t a l f i b r o s i s a n d i n t r a c e l l u l a r cholestasis. A l l l i v e r function t e s t s were normal when discharged a t age 19 months. He was readmitted s i x months l a t e r w i t h fever, hepatomegaly, icterus, and melanotic stools, and expired a f t e r the onset o f massive GI hemorrhage. At autopsy, two separate hepatic tumor masses were found, one o f which had