**Core Concept**
Fibrolamellar carcinoma (FLC) of the liver is a rare subtype of hepatocellular carcinoma (HCC) characterized by its distinct histological features and clinical behavior. Unlike the more common HCC, FLC typically occurs in younger individuals without underlying liver disease or cirrhosis.

**Why the Correct Answer is Right**
Fibrolamellar carcinoma is known for its distinct clinicopathological features, including a strong association with young adults (average age 20-30 years) and a lack of cirrhosis. A key distinguishing feature of FLC is its low serum alpha-fetoprotein (AFP) levels, which are usually 1000 mg/L are common. Therefore, option D is incorrect because FLC is not typically associated with high serum AFP levels.

**Why Each Wrong Option is Incorrect**
**Option A:** Females do not have increased incidence than males - This statement is true, as FLC has a slight male predominance. However, this is not the correct answer, but rather a distractor.
**Option B:** Has good prognosis - While FLC has a better prognosis compared to traditional HCC, this statement is somewhat misleading. FLC is still a malignant tumor with potential for metastasis and recurrence.
**Option C:** Not associated with liver cirrhosis - This statement is true, and FLC can be distinguished from traditional HCC by its lack of association with underlying liver disease or cirrhosis.

**Clinical Pearl / High-Yield Fact**
A key differentiating feature of FLC is its distinct histological appearance, characterized by the presence of fibrous bands and a lack of tumor differentiation. This should prompt clinicians to consider FLC in the differential diagnosis of young patients with liver tumors.

✓ Correct Answer: D. Serum AFP levels are usually >1000 mg/ltr