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<p>Abstract</p> <p>Background</p> <p>The worldwide experience of surgical resection for isolated metastasis following liver transplantation (LT) for hepatocellular carcinoma (HCC) is limited.</p> <p>Methods</p> <p>The case of a 60-year-old patient performed successful surgical management for metachronous pulmonary and adrenal metastases from HCC after LT.</p> <p>Results</p> <p>Eighty months after LT, he was presently alive and disease-free with a normal AFP value.</p> <p>Conclusion</p> <p>The case is an interesting report on a somehow indolent metastatic spread of HCC after LT. It should be considered that metachronous metastatic resectable disease, with no data of recurrence at the primary site in an operable patient, is an indication to perform a surgical resection.</p>