Abstract
Hepatocellular carcinoma (HCC) typically presents with abdominal pain, jaundice, or hepatic decompensation. However, peripheral edema as an initial presentation is uncommon and may lead to diagnostic delays. Here, we report the case of a 77-year-old woman with underlying diabetes mellitus, hypertension, and dyslipidemia who presented with bilateral leg swelling. Cardiac and renal evaluations were unremarkable. Liver function tests revealed mild derangement. Further investigations, including abdominal imaging and elevated alpha-fetoprotein levels, confirmed the diagnosis of HCC. This case highlights the importance of considering hepatic malignancy in patients presenting with unexplained peripheral edema. A comprehensive clinical evaluation and timely imaging are crucial for early diagnosis and improved patient outcomes.