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Hepatocellular Carcinoma Presenting as Dyspnea at Rest due to Innumerable Lung Metastasis. Hepatocellular carcinoma (HCC) the most common primary tumor of the liver usually develops in the setting of chronic liver disease. The presentation is usually due to worsening of chronic liver disease or being detected incidentally on imaging. Rarely metastasis to distant organ becomes the presentation. The authors describe a case of a 70-year-old woman who presented with dyspnea of 2 weeks duration. She was diagnosed as having HCC and extensive multiple pulmonary metastases. She was symptomatic only for the pulmonary metastasis with only 2 lesions in the liver. Because of advanced nature of disease, no specific therapy for the tumor was possible.