Background: The hepatocellular carcinoma, is detected sooner due to the progress of the hepatic ultrasound scan allowing an accessibility to curative treatment. This cancer treatment still remains difficult in Tunisia.

Aim: To show the difficulties in the management of the hepatocellular carcinoma in Tunisia.

Methods: Patients hospitalized in the gastroenterology department of Habib Thameur Hospital, from 2002 until 2007, for a cirrhosis follow-up or for a hepatocellular carcinoma treatment were studied retrospectively. The data was summarized by descriptive statistics and analysed with SPSS version 10.

Results: Fifty-seven patients were registered in this study. There were 40 males with an average age of 66 years. The cirrhosis was post-viral C in 28 cases. The discovery of the carcinoma was systematic in 16 cases. Treatment was prescribed in only fifteen patients, in the other patients, treatment was not made because of the multifocal character of the hepatocellular carcinoma. Complications were cirrhosis decompensation (n=3), fever (n=3), portal thrombosis (n=1) and pleurisy (n=1).

Conclusion: Regardless of the improvement of diagnostic and therapeutic means, 17.5% of our patients having a hepatocellular carcinoma were subjected to a curative treatment. An additional effort must be unfolded.

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