A 47-year-old woman was admitted in our surgical department for further treatment of liver cancer that had been found incidentally 2 years ago. No specific symptoms were mentioned except vague abdominal pain. The levels of tumor markers (CEA, CA 19-9, CA 15-3) were within normal ranges. The patient's medical history included once splenic artery embolization and twice TACE (2 years ago), liver cancer resection (2 years ago), ultrasound-guided percutaneous Radiofrequency ablation (5 months ago, resulting in tumor enlargement). The computed tomography (CT) imaging of the abdomen showed a mass located in right liver and a tumor thrombus located in main portal vein and right portal vein. A liver magnetic resonance (MR) images also confirmed a 122*102*116mm mass located at V-VI-VII segment of liver, the tumor thrombus in MPV and RPV was also found. The patient underwent a thrombectomy and right hepatectomy, the transection margin was tumor-free. Postoperative pathology confirmed the diagnosis of Hepatocellular Carcinoma, the tumor thrombus was also found by pathology department in the large veins and microvessels of the liver. The patient is now in good condition and is accepting follow-up treatment in our department.