A 62-Year-Old Man with Weakness and Weight Loss for 3 Months

Metabolic dysfunction-associated steatotic liver disease (MASLD) is emerging as a major cause of hepatocellular carcinoma (HCC) worldwide, driven by the increasing prevalence of obesity and metabolic disorders. The pathogenesis of MASLD-related HCC is multifactorial, involving insulin resistance, chronic inflammation, oxidative stress, genetic susceptibility, and alterations in the gut microbiome. While surveillance is well established for patients with cirrhosis, optimal strategies for non-cirrhotic MASLD remain unclear despite a substantial proportion of HCC arising in this population. Non-invasive tests, biomarkers, and novel approaches such as liquid biopsy may improve risk stratification and early detection. Further prospective studies are needed to establish effective, cost-efficient surveillance strategies.