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Background: Most of the reports on tumor relapse are recurrence of the same type of tumor after months to few years of a successful initial cancer treatment. It is generally unusual and unexpected that a different type of the second tumor occurs after several decades of the curative treatment of the original tumor. Case Presentation: We report a case of 74-year-old man with intrahepatic cholangiocarcinoma (ICC) diagnosed 38 years after curative resection of hepatocellular carcinoma (HCC). In addition to the uniqueness of longer survival and developed a new type of tumor, both the original HCC and the later occurred ICC were detected through a cancer surveillance program by screening alpha-fetoprotein (AFP) and ultrasonography of the liver for the general population and/or high risk group of people who were asymptomatic. Conclusion: This report provides evidence demonstrating occurrence of new type of tumor following initial curative therapy of the original tumor. In addition, this case report also highlights the importance of cancer surveillance program for earlier detection of the tumors to achieve a remarkably improved prognosis of the cancer patients for a prolonged cancer free survival time.