The occurrence of three primary malignancies in a single patient is an infrequent phenomonen with an estimated occurrence at 0.1％. Notably, patients with hepatocellular carcinoma (HCC) are particularly unlikely to develop extrahepatic primary malignancies. In this light, we present a case of patient with chronic hepatitis B who developed HCC, as well as two other primary malignancies. This case exhibits an exceedingly rare combination of cancers, underlining the importance of continued cancer surveillence in those with a history of primary malignancy.