The patient was a 91-year-old man. He underwent a medical examination for hypertension and chronic atrial fibrillation, during which a mass was palpated through the abdominal wall. He was then referred to our hospital. Laboratory data were as follows: aspartate aminotransferase (AST) 61 IU/l (normal 5-35), alanine aminotransferase (ALT) 37 IU/l (normal 5-30), alkaline phosphatase (ALP) 334 U/l (normal 115-359), gamma-glutamyl transferase (gamma-GTP) 230 IU/l (normal 0-50), lactate dehydrogenase (LDH) 177 IU/l (normal 106-211), albumin (Alb) 3.6 g/dl (normal 3.7-5.5), total bilirubin (TB) 0.71 mg/dl (normal 0.2-1.0), and prothrombin time-international normalized ratio (PT-INR) 1.03. Child-Turcotte-Pugh grade was A. The indocyanine green retention rate at 15 min (ICG-R15) was 8%. The concentration of serum alpha-fetoprotein (AFP) was 3,600 ng/ml (normal <20) and plasma des-gamma-carboxy prothrombin (DCP), also known as protein induced by vitamin K deficiency or antagonist-II, was 93,300 mAU/ml (normal <40). No serological evidence of hepatitis B or C was seen. Contrast-enhanced computed tomography (CECT) revealed a tumor measuring 78 mm in diameter in the left lateral sector of the liver (fig. 1). HCC was suspected. The patient requested radical surgery, so left lateral sectorectomy was performed (fig. 2). The operation time was 370 min, and the amount of blood loss was 978 ml. Pathological findings revealed well to moderately differentiated HCC (fig. 3).