Objective To investigate the differential diagnosis between atypical hepatic abscess and hepatocellular carcinoma.Methods CT reexamination after admission, other tests, and medical history were comprehensively analyzed for differential diagnosis in seven patients newly diagnosed with liver cancer.Results Atypical liver abscess patients had a history of fever, effective antibiotic treatment, AFP negative, low hepatitis b virus carrier rate, and low cirrhosis rate.In particular, all the four patients who delayed the CT reexamination showed hive-like change of liver abscess, namely the cluster-like sign, thus avoiding surgical injury.Conclusion In addition to the data of medical history and examination, it is of great significance to delay the reexamination of CT (about two weeks after the initial examination) for the differential diagnosis of undiagnosed liver occupying lesions if the treatment allows.