The initial abdominal CT showed a round hypodense nodule with a well-demarcated margin in segment VIII measuring 1.5 × 1.5 cm, with no contrast enhancement (Fig. 1A). To differentiate malignant tumor, we performed magnetic resonance imaging. The tumor was hypointense in T1-weighted images (Fig. 1B) and showed subtle hyperintensity on T2-weighted images and rim enhancement during the arterial phase (Fig. 1C and 1D). The portal and delayed phases showed homogenous hypointensity (Fig. 1E).

The tumor was biopsied under ultrasound guidance. The histology revealed an encapsulated necrotic lesion with mild lymphocyte, plasma cell, and histiocyte infiltration. The surrounding lesion revealed normal hepatic parenchyma with few neutrophils and lymphocytes (Fig. 2A and 2B). Based on the image and histology findings, a solitary necrotic nodule of the liver was diagnosed. Follow-up CT after 7 months showed that the lesion had decreased in size to 1.3 × 0.95 cm. It was still hypointense compared with the normal liver parenchyma, without detectable enhancement (Fig. 1F).