Multimodal Imaging in Intrahepatic Cholangiocarcinoma Misdiagnosed as Liver Abscess: A Case Report

Intrahepatic cholangiocarcinoma (ICC) often mimics liver abscess in clinical presentation and imaging features, leading to misdiagnosis. We report a case of a 56-year-old male initially diagnosed with liver abscess. Multimodal imaging, including contrast-enhanced computed tomography (CECT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS), revealed rim-enhancing lesions, making definitive differentiation challenging. Ultrasound-guided biopsy confirmed the diagnosis of ICC. This case, combined with a literature review, systematically explores the key imaging features for differentiating ICC from liver abscess, analyzes potential reasons for misdiagnosis, and proposes an integrated diagnostic strategy emphasizing the crucial role of pathological confirmation, particularly in equivocal cases.