Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, and has a poor prognosis. In this study, we reported an exceptional clinical case of primary HCC with metastatic disease in the lungs 1 year following hepatic resection, and in the left adrenal gland 8 years following hepatic resection. Comprehensive treatments, including partial hepatic resection, systemic chemotherapies with various regimens, such as radiotherapy, were administered to this patient. In this case, there was no intrahepatic recurrence of the malignancy and the metastatic disease was sensitive to chemotherapy and radiotherapy. The patient remained alive and in good health for 10 years following the diagnosis of HCC despite early metastatic disease. This indicates that for certain patients with advanced stage HCC, palliative treatments may still be beneficial to their survival. We also discussed the advance in recent research into HCC treatment.