Histological diagnosis of HCC was confirmed. This is a unusual case of HCC containing microscopic fat (signal drop on opposition phase images). In cirrhotic patient, more than 80 % of microscopic fat containing lesions are malignant, most of which are HCCs.

The differential diagnosis of fat containing liver lesions includes :

Benign:

• focal fatty change (focal steatosis)
• adenoma
• FNH
• lipoma
• angiomyolipoma
• cystic teratoma
• cystic adrenal rest tumor
• pseudolipoma of the Glisson capsule
• xanthomatous lesions in Langerhans cell histiocytosis (LCH)

Malignant:

• HCC
• metastastic liposarcoma
• primary liposarcoma
• other fat containing liver metastases