Data concerning primary carcinoma of the liver previous to 1870 are apparently not to be relied on, as primary and metastatic carcinomas were not well differentiated. The many writers reporting primary carcinoma of the liver agree that it is rare. In 1890, von Hansemann1gave a report of 258 cases of malignant epithelial tumors of the liver, four of which were primary. Goldzieher and von Bokay,2in a series of 6,000 necropsies, found eighteen definite primary carcinomas. Eggels,3in his review of the literature up to 1901, reported 163. Karsner4reviewed the literature up to 1911, and reported nine cases coming under his observation. Winternitz5summarized the reports up to 1916, and decided that primary carcinoma of the liver occurred in from 0.028 to 0.3 per cent, of all necropsies. In a series of 3,700 postmortem examinations at the Johns Hopkins Hospital, he found three