Most HCC are asymptomatic at diagnosis, being incidental findings, or are found via a surveillance program.

The best outcomes for HCC are in cases detected by screening or surveillance via an ultrasound before the patient develops overt symptoms.

The following signs, symptoms or results should be investigated:

• right upper quadrant abdominal pain or discomfort
• a hard lump on the right side of the abdomen
• significant weight loss
• abnormal liver function tests
• worsening liver failure (jaundice, ascites, portal hypertension)
• constitutional symptoms including night sweats and anorexia.

Multiple signs and symptoms, particularly in combination with other underlying risk factors, indicates an increased risk of HCC.