Tehran University of Medical Sciences Basic & Clinical Cancer Research 2228-6527 12 4 2021 02 16 201 206 Adeleh Shirvan Palliative Medicine Unit, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Sarvazad Sotoudeh Radiation Oncology Research Center (RORC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran Mamak Tahmasebi Department of Palliative Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2019 12 31 Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare primary liver tumor that affects young adults, with unknown biology. We present a case of 21‐yr‐old female with a liver tumor revealed by hemangioma feature at first presentation, after few months, presented with metastatic liver cancer. In pathologic investigation fibrolamellar hepatocellular carcinoma was confirmed. In spite of liver mass resection and lung metastasectomy, after short time, tumor recurrence was occurred. In 18F-FDG PET-CT scan ,lung, ovary, colon and peritoneal invasion was reported. Unfortunately, The patient died one year after diagnosis with rapid progression and multiple unusual metastatic site. Here, we also review the literature concerning FLHCC in many aspects. https://bccr.tums.ac.ir/index.php/bccrj/article/view/330