Challenges in metastatic hepatocellular carcinoma: beyond tumor stage in guiding treatment.

Extrahepatic metastases in hepatocellular carcinoma (HCC) often signify a poor prognosis. This case details the five-year survival of a patient with HCC and adrenal metastasis managed with an aggressive multimodal approach, including ablation, systemic therapy, and surgical resection. Despite therapeutic advances, metastatic HCC management remains a clinical challenge, underscoring the need for individualized treatment strategies beyond traditional staging systems. Further research is essential to determine the role of surgical resection and other treatment modalities in the metastatic setting.