Fig. 1

Sites of hepatocellular carcinoma recurrence after liver transplantation. Tumor recurrence is mainly extrahepatic, particularly in the lungs (40–60%) and bones (25–30%). Other extrahepatic locations of recurrent HCC are the adrenal glands (~ 10%), lymph nodes (~ 10%), peritoneum (~ 10%), brain (~ 4%), and rarely soft tissues/muscles of the thoracic and abdominal wall. Extrahepatic-only recurrence accounts for 50–60% of cases. Liver and extrahepatic recurrence occurs in 30–40% of cases. Liver-only recurrence accounts for 15–40% of cases