Abstract

Isolated hepatic actinomycosis (IHA) is a rare infectious disease, which presents as a space-occupying lesion. We present a case of pathologically proven liver actinomycosis. Ultrasonography and computed tomography scan revealed a large solitary liver mass. The mild heterogeneously enhancing mass appeared as a hypointense area on a T1-weighted image and as a hyperintense area on a T2-weighted image, with a peripherally enhancing rim, and mimicked the appearance of a peripheral cholangiocarcinoma (PCC) on magnetic resonance imaging (MRI). However, the mean apparent diffusion coefficient (ADC) value (0.78 × 10^(-3) s/mm^2) of the mass obtained from diffusion-weighted MRI (DW-MRI) was significantly lower than that of PCCs. IHA is characterized by extension of the mass to the abdominal wall and the presence of numerous honeycomb-like septa within the mass. IHA generally responds well to antibiotic therapy but is easily misdiagnosed. Knowledge of the radiological features of IHA is essential for avoiding delayed treatment and unnecessary surgery.

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