Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) usually affects patients aged 50-70 years but earlier onset (25-40 years) may occur in hepatitis B endemic areas. 70-90% of HCC develop on a background of cirrhosis. However, hepatitis B virus is directly oncogenic and can cause HCC in the absence of cirrhosis. This may represent a major cause of death from late diagnosis in resource-limited areas. CASE PRESENTATION: We report a black African family in which clinical diagnosis of HCC was made on two male siblings in the south west region of Cameroon. CONCLUSIONS: The highest risk for HCC may occur in families in which a hereditary component may be acting in concert with hepatitis B virus. In all cases of HCC, it is important to screen all first degree relatives to detect early and asymptomatic disease.