The patient is a middle-aged male with a history of hepatitis B. He came to the emergency department during a visit to his family in Shenzhen because of abdominal pain, and was found to have diffuse hepatocellular carcinoma of the liver and portal vein thrombosis on ultrasound. Further MRI examination was performed as follows: Shenzhen People’s Hospital, Department of Interventional Medicine, Wu Yuxuan, T2 image of the liver. A diffuse slightly high signal tumor in the right liver with unclear border was seen. MRI-enhanced portal phase shows a diffuse, low-signal lesion in the right liver, and the portal vein fails to show, suggesting portal vein cancer thrombosis. The MRI-enhanced coronal scan showed a diffuse lesion with tumor invasion of the left and right branches of the portal vein, but the main trunk of the portal vein still showed blood flow signal. The patient was a farmer in the Central Plains, without medical insurance. At that time, he had grade B liver function, elevated AFP and poor general condition. Considering the patient’s poor prognosis, pain relief and supportive treatment were suggested to avoid the ending of both people and money. However, after repeated communication with the patient, the patient’s family refused to give up and demanded active treatment. After multiple consultations, professors from outside hospitals suggested sorafenib treatment, and considering the patient and family’s strong desire for treatment and the high price and limited efficacy of sorafenib, they agreed to give interventional treatment and did not recommend sorafenib. This picture shows the end of the second interventional treatment. The imaging shows that there is a hepatic artery-portal vein shunt, a huge tumor in the right liver with rich arterial blood supply, and there are more iodine oil deposits in the lesion after the operation. After the third intervention, the lesion was significantly reduced in size and the border was clear. 6 segments showed multiple small subfoci with good iodine oil deposition. Radiofrequency ablation treatment was performed under CT guidance. The tumor was punctured with a set of RF electrodes and ablation treatment was performed, and concentric artifacts were seen during the ablation process. Six months after ablation, the lesion showed non-enhancing low signal with clear borders. No surviving tumor was also seen in the remaining liver. After treatment, the MRI was coronal and the portal vein was clear without cancerous thrombus. The right liver had normal signal, no residual tumor was seen, and the original right liver diffuse tumor disappeared. The lesion was well defined and showed non-enhancing low signal, which was changed after ablative treatment. The CT was repeated three months later and showed that the hepatic vein was intact and no surviving tumor was seen in the liver. The tumor was completely inactivated, no surviving tumor was seen, and the portal vein cancer thrombus disappeared. After ablation treatment, CT and MR showed complete inactivation of the lesion without enhancement, patency of the portal vein, no cancer thrombus, patency of the hepatic vein and vena cava. The patient achieved tumor-free survival. Comment: The patient had diffuse liver cancer and portal vein thrombus, which is generally considered to have no surgical and interventional value and can only be treated supportively. This case also reminds us that there is no absolute contraindication for interventional treatment of hepatocellular carcinoma. Under the premise of mutual trust and adequate communication between doctors and patients, the excellent skills of doctors may create a medical miracle.