We report the cases of four families in whom 2 or 3 cases of hepatocellular carcinoma were observed. In the first family, the mother and 2 daughters had hepatocellular carcinoma. In 2 other families, 2 brothers had hepatocellular carcinoma. In the first three families, all patients with hepatocellular carcinoma, as well as other members of these three families, were chronic HBsAg carriers. In the fourth family, hepatocellular carcinoma developed in 2 brothers with HBsAg negative Mediterranean cirrhosis. Because of the high risk of hepatocellular carcinoma in chronic HBsAg carriers, it is conceivable that the occurrence of familial cases of hepatocellular carcinoma could be fortuitous. However, we cannot exclude the possibility of the familial predisposition to hepatocellular carcinoma. Therefore, it seems wise, when hepatocellular carcinoma develops in one patient in a family, to carefully monitor other members of this family, whether HBsAg positive or with non A non B chronic hepatitis, for the development of hepatocellular carcinoma.
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