Abstract
A man in his 70s with antiphospholipid syndrome (APS) presented with a hepatic mass. Initial imaging suggested hepatic infarction, as the liver tumor markers were normal, and coagulation tests indicated a hypercoagulable state. Three years later, follow-up imaging revealed tumor enlargement, leading to a biopsy-confirmed hepatocellular carcinoma diagnosis. Transarterial embolization was performed followed by lenvatinib therapy. The patient achieved complete response with no recurrence for over eight months. This case highlights the potential of APS to contribute to liver carcinogenesis in non-cirrhotic patients and illustrates the need for individualized treatment strategies.