The 1-year survival rate of patients with unresectable hepatocellular carcinoma is less than 50%, which indicates a poor prognosis. Recently, the combination of atezolizumab and bevacizumab has improved the prognosis of patients with advanced hepatocellular carcinoma and has become the first-line treatment for unresectable hepatocellular carcinoma. However, there are few reports on conversion surgery after chemotherapy for unresectable hepatocellular carcinoma. Here, we report the case of a 92-year-old man with no significant complaints. During follow-up, the tumor was found to be enlarged, and abdominal MRI revealed a tumor in S4-1 and S8 of the liver. We diagnosed the tumor as an unresectable hepatocellular carcinoma. After atezolizumab and bevacizumab combination therapy, we evaluated the partial response(PR)using the response evaluation criteria in solid tumors(RECIST)and performed laparoscopic cholecystectomy and left lobectomy. There are no established indications for conversion surgery for unresectable hepatocellular carcinoma after combination therapy with atezolizumab and bevacizumab, and more cases should be studied to determine the indications and optimal timing of conversion surgery.
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