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Hell Cave has no key item in the game files; its pickups and crates are listed below.
Hell Cave is Cave E in the game files, drawn here from the cave's own collision floor. It spans about 912 m and has 5 floors: F1 at -20 to 25 m, F2 at -65 to -20 m, F3 at -115 to -65 m, F4 at -160 to -115 m, F5 at -205 to -160 m. It has 2 entrances or exits: Hell Cave door, Boss cavern end. The files place 103 item pickups and 16 crates with loot tables in it. Switch the map above to the underground layer, pick a floor in the stack on the right and open a pin to see what lies there. The surface returns with the mountain button.