Small hepatocellular carcinoma is relative to large hepatocellular carcinoma. Small hepatocellular carcinoma is also called subclinical hepatocellular carcinoma or early hepatocellular carcinoma, which has no obvious clinical signs and symptoms. Small hepatocellular carcinoma generally refers to hepatocellular carcinoma in which the maximum diameter of a single cancer nodule does not exceed 3 cm or the sum of the diameters of two cancer nodules does not exceed 3 cm. Patients often have no clinical symptoms. The tumor nodules are mostly spherical in shape, with clear boundary, uniform cut surface and no bleeding and necrosis. The standard of small hepatocellular carcinoma in China is: the maximum diameter of a single cancer nodule should not exceed 3 cm; the number of multiple cancer nodules should not exceed two, and the sum of their maximum diameter should be less than 3 cm. 1. The differentiation of small hepatocellular carcinoma is mostly related to the size of cancer foci. About 75% of very small cancer foci are mainly grade I, grade II is rare, and the tissue structure is mainly well-differentiated beam-like. Flow cytometry showed that 66.7% of small hepatocellular carcinoma cells were mainly diploid, and the polyploidy and heteroploidy increased with the increase of tumor size. 2.Small hepatocellular carcinoma has the characteristics of swelling growth and infiltrative growth. Small hepatocellular carcinoma with swelling growth is spherical with clear boundary and about 60% have envelope; those with infiltrative growth have irregular boundary, no envelope formation and inflammatory infiltration around the carcinoma. 3.Small hepatocellular carcinoma is rarely accompanied by satellite nodules (3%). About 30 small hepatocellular carcinomas have intravascular cancer thrombus microscopically. Individual small hepatocellular carcinoma is accompanied by distant metastasis. 5.Many small hepatocellular carcinomas have liver disease around the cancer. Among them, 80% are combined with hepatic sclerosis and 75 have chronic hepatitis. Symptoms of small hepatocellular carcinoma: The symptoms of small hepatocellular carcinoma are not obvious, or even there is no feeling for a long time after the disease. Only when the disease has developed to a certain extent will it gradually produce some symptoms such as pain in the liver area, decreased appetite, fatigue and weakness, and gradual loss of weight. Treatment of small hepatocellular carcinoma: There are various treatments for small hepatocellular carcinoma, including partial hepatectomy, liver transplantation, interventional embolization, radiotherapy and Chinese medicine. Since small liver cancer is small, it has a better chance of surgical resection, so once it is found to be small liver cancer, it should be resected as early as possible. However, partial hepatectomy is more traumatic and is often affected by factors such as liver function status, liver cancer site and patients’ economic condition. It is not an ideal choice for patients with a heavy background of cirrhosis. Interventional embolization can be a treatment option for small hepatocellular carcinoma that cannot be resected surgically, but its efficacy is limited by the arterial blood supply to the tumor, and it is often difficult to completely kill the hepatocellular carcinoma. Since arterial blood supply is often not abundant in small hepatocellular carcinoma, it is less valuable than large hepatocellular carcinoma for small hepatocellular carcinoma. Liver transplantation for small liver cancer is one of the indications for liver transplantation. Liver transplantation also has satisfactory efficacy in treating small hepatocellular carcinoma and is almost the only option for those patients with poor to nearly non-functional liver function. However, liver transplantation is costly, often has some serious complications, and requires lifelong treatment. At this stage in China, the majority of patients cannot afford the huge cost of liver transplantation. Radiotherapy has strong toxic side effects and relatively poor clinical efficacy, but if the patient’s physical condition allows, the necessary radiotherapy can be carried out appropriately. Nevertheless, Chinese medicine treatment should be used throughout the whole treatment process, such as the use of spleen and stomach strengthening methods during chemotherapy to reduce the toxic side effects of radiotherapy, and the use of tumor suppressing herbs during the interval to improve the patient’s immune function and prevent tumor recurrence or even the purpose of complete recovery.