本文报告4例肝原发病灶症状尚不明显而转移病灶的症状为其首发临床表现的原发性肝癌。4例病例的共同特点是就诊时仅发现有肝外转移病灶,而肝内未能发现占位性病变。AFP均>400ng′ml。初诊时均误诊为良性肿瘤。确诊依据为病理检查。病人虽属晚期,因其肝内病灶出现较晚,生存期相对较长。 This article reports the symptoms of metastatic liver lesions in 4 cases with unpredictable hepatic lesions as the primary clinical manifestation of primary liver cancer. The common feature of the four cases was that only extrahepatic metastatic lesions were found at the time of diagnosis, and no occupying lesions were found in the liver. AFP all> 400ng’ml. All were misdiagnosed as benign tumors at the time of initial diagnosis. The diagnosis is based on pathological examination. Although the patient is late, because of the late appearance of liver lesions, the relatively long survival period.