We report a case of a 40-year-old man of Bantu origin, affected by both HBV infection and primitive hepatocarcinoma in the absence of cirrhosis. The fine-needle aspiration specimen reported a rare variant of liver cancer resembling an adenocarcinoma. The neoplasm was certainly a hepatic primitive carcinoma, because chest X-ray, cranial computed tomography, colonoscopy, and abdominal computed tomography did not detect neoplastic lesions and alpha-fetoprotein was > 1000 ng/mL. The present neoplasm, characterized by severe portal hypertension and absence of cirrhosis, is rare in Italy, but largely diffused in Bantu people in Africa.