This is a 72-year-old male patient with a personal history of type 2 diabetes mellitus and hypercholesterolaemia under pharmacological treatment, with no family history of interest or previous surgery. He was referred by his primary care physician for a three-week history of general malaise, a feeling of dizziness and dull pain in the right hypochondrium. There were no recent alterations in intestinal transit, rectorrhagia or melaenic stools. Physical examination revealed only a mildly painful abdominal palpation in the right hypochondrium, with no visceromegaly. Laboratory tests showed: leukocytes: 14.3 x 109/L (85% neutrophils); haemoglobin: 11.7 g/dL (MCV: 89.7 fL, MCH: 29.2 pg); LDH: 203 U/L; GOT: 71 U/L; GPT: 104 U/L; GGT: 311 U/L; alkaline phosphatase: 526 U/L; total bilirubin: 0.74 mg/dL. Serologies for hepatotropic viruses, Brucella and Echinococcus, as well as serial blood cultures and determination of tumour markers, were negative or within normal ranges. Abdominal ultrasound revealed a space-occupying lesion in the right hepatic lobe (8.5 x 6.8 cm), polylobulated, with cystic-like areas inside. Abdominal-pelvic computed tomography (CT) with contrast confirmed this image, which showed hypodense areas with peripheral enhancement, being overall highly suggestive of liver abscess. Fine-needle aspiration obtained abundant purulent material, the cytological analysis of which was congruent with acute inflammation of a non-specific nature, with no evidence of malignancy. Microbiological culture and parasite examination of the aspirate were negative. After the administration of broad-spectrum antibiotic therapy (ceftriaxone, metronidazole and gentamicin) and the implantation of percutaneous drainage, a favourable clinical evolution was obtained, with practical remission of the lesion in a subsequent radiological control. In order to investigate possible underlying pathogenic conditions, a colonoscopy was performed, which identified an exophytic lesion close to the ileocaecal valve, suspicious for malignancy; the anatomopathological study confirmed the diagnosis of adenocarcinoma of the cecum. The extension study did not reveal metastatic dissemination or other lesions in the liver, and a right hemicolectomy was performed with subsequent administration of adjuvant chemotherapy (capecitabine). The patient remains free of disease after 14 months of follow-up.