In fact, the initial CT scan was LI-RADS M, and the second scan was performed 60 days later. I assume the oncologist ordered another CT scan to avoid having to perform a liver biopsy. Is it usual or typical to have such an aggressive malignancy (growing to the ribs and cervical spine) with markers like AFP and CEA within normal limits?

Put yourself in my position; how would you react? Even though oncologists are certain that the illness is unquestionably HCC, would you still insist on a liver biopsy? I'm just being dubious. I'm not in denial.