With the advancement of hepatocellular carcinoma treatment technology, many hepatocellular carcinomas involving large blood vessels can be saved. In different stages of hepatocellular carcinoma, the incidence of involvement of portal trunk is 20-80%, the incidence of involvement of major hepatic veins is 10-25%, the incidence of inferior vena cava thrombosis is 2-20%, and even right atrium thrombosis occurs in 1-2%. Most of the cancer emboli in the main portal vein of liver cancer can be removed or excised surgically, while those involving the hepatic vein can be removed together with the liver cancer. Some of the cancer emboli in the hepatic vein, inferior vena cava or atrium may be dislodged at any time and cause acute pulmonary embolism, thus leading to sudden death. Most doctors give up the treatment of this part of patients because of the fear of death caused by the dislodgement of cancer emboli during surgery. In our practice, we have also achieved very good results by using appropriate techniques to control the dislodgement of the cancer thrombus, dissect the inferior vena cava, and even open the right atrium, and remove the cancer thrombus and remove the tumor. This is a case where the tumor invaded the inferior vena cava and grew into the right atrium with the inferior vena cava. We successfully removed the cancer thrombus from the right atrium and inferior vena cava under extracorporeal circulation, and removed the tumor from the right lobe of the liver. Figure 1 Atrial cancer thrombus Figure 2 Inferior vena cava cancer thrombus Figure 3 Inferior vena cava cancer thrombus Figure 4 Atrial cancer thrombus removed during surgery Figure 5 Postoperative CT review indicates that the cancer thrombus has been removed With the improvement of diagnostic techniques, more and more patients with combined inferior vena cava and/or atrial cancer thrombus can be diagnosed before the cancer thrombus is dislodged, and with the improvement of surgical techniques, these patients with hepatocellular carcinoma with inferior vena cava and/or atrial cancer thrombus, which were previously classified as incurable, can also be diagnosed before the cancer thrombus is dislodged. These patients with inferior vena cava and/or atrial thrombosis, which were previously considered incurable, have been given a new lease of life with improved surgical techniques. Our liver cancer center has successfully performed many similar patients with embolus removal + tumor resection, which has saved more liver cancer patients.