81 year old female patient, increased fatigue and decreased performance since 1 year. CRP, G-GT, Alkal. Phophatase slightly elevated => external MRI with suspicion of malignant liver lesion. Inhomogeneous hepatic cavity on ultrasound => presentation for CEUS. CEUS revealed uncontrasted hepatic mass. In combination with the 2d-image suspicious for echinococcus multilocularis. Patient confirmed 40-years of dog contact. Echinococcus titer positive (IHAT 1:1280). Albendazole therapy started. Patient was not operable due to age and comorbidities.