Intrahepatic cholangiocarcinoma mimicking a hypervascular mesenchymal tumor: a case report

This article reports a case of multifocal intrahepatic cholangiocarcinoma (iCCA) with imaging findings that are easily misdiagnosed and serological tests are completely negative and reveal its key diagnostic pitfalls. The patient was a 54-year-old female who presented with abdominal discomfort. Serum tumor markers were normal. Enhanced computed tomography showed marginal enhancement in arterial phase, slow centripetal filling in delayed phase, and target sign (high signal and low signal ring) in hepatobiliary phase of magnetic resonance imaging. iCCA was finally diagnosed by pathology. This case emphasizes that even with negative tumor markers, iCCA should be considered in patients with atypical imaging manifestations, especially with "target-like" signs. Early pathological biopsy is the key to avoid misdiagnosis and ensure accurate treatment.