2 cm with an AFP > 400 ng/ml (or 400 ,ug/L) is highly * suggestive of HCC. Percutaneous liver biopsy under U/S or CT guidance can be diagnostic, but the sample should be drawn with caution as these tumors tend to be vascular. Thorotrast (colloidal thoriune dioxide) is an angiographic medium that was used in 1930s. It emits high levels of long-lasting radiation. It has been associated with - hepatic fibrosis - hepatocellular carcinoma - cholangiosarcoma and - ngiosarcoma About Aflatoxin Harrison writes- "Probably the best-studied and most potent ubiquitous natural chemical carcinogen is a product of the Aspergillus fungus, called atlatoxin B1. This mold and aflatoxin product can be found in stored grains in hot, humid places, where peanuts and rice are stored in unrefrigerated conditions. Aflatoxin contamination of foodstuffs correlates well with incidence rates in Africa and to some extent in China." Because of multicentricity, bilobar involvement, poal vein invasion, and lymphatic metastasis only 15-20% of hepatocellular carcinomas are resectable.">