**Core Concept**
Hepatocellular carcinoma (HCC) is a primary malignancy of the liver, often arising in the setting of chronic liver disease and cirrhosis. The etiology of HCC is multifactorial, involving both viral and non-viral risk factors.

**Why the Correct Answer is Right**
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are two of the most significant risk factors for HCC, accounting for a substantial proportion of cases worldwide. HBV and HCV infections lead to chronic liver inflammation, which can progress to cirrhosis and eventually HCC. Cirrhosis, regardless of its etiology, is a well-established risk factor for HCC, as it creates a microenvironment conducive to tumorigenesis. Fibrolamellar HCC is a rare variant of HCC that typically occurs in younger individuals without underlying liver disease, including cirrhosis. However, this does not exclude the possibility of fibrolamellar HCC arising in a cirrhotic liver.

**Why Each Wrong Option is Incorrect**
**Option A:** While HBV and HCV are indeed risk factors for HCC, they are not the only factors. Other risk factors, such as non-alcoholic fatty liver disease (NAFLD), alcohol abuse, and aflatoxin exposure, also contribute to the development of HCC.

**Option B:** While cirrhosis is a predisposing factor for HCC, it is not the only factor. Other risk factors, such as HBV and HCV infections, can also lead to HCC in the absence of cirrhosis.

**Option C:** While fibrolamellar HCC is not typically associated with cirrhosis, it is not entirely excluded as a possibility. However, this option is not entirely incorrect, as fibrolamellar HCC is a distinct clinical entity with different risk factors and characteristics compared to classical HCC.

**Clinical Pearl / High-Yield Fact**
It is essential for clinicians to be aware of the various risk factors for HCC, including viral hepatitis, cirrhosis, and other underlying liver diseases. Regular screening and surveillance of high-risk patients can lead to early detection and treatment of HCC, improving outcomes and survival rates.

**✓ Correct Answer: D. All**