Imaging feature associated with mass-forming intrahepatic cholangiocarcinoma.

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Capsular retraction of the liver is a characteristic imaging feature of mass-forming intrahepatic cholangiocarcinoma. The tumor drives a dense desmoplastic fibrotic reaction, which pulls the liver capsule inward around the lesion, producing indentation or inward bowing of the liver contour on CT or MRI. This sign helps distinguish cholangiocarcinoma from other focal liver processes, and it often accompanies the typical contrast-enhancement pattern of iCCA (limited arterial enhancement with progressive fill-in on delayed phases).

Beading of biliary ducts with irregular strictures can occur with biliary disease like PSC or cholangiocarcinoma involving ducts, but it’s not the hallmark feature of the mass-forming type. Diffuse hepatic steatosis is a diffuse metabolic change, not related to a focal mass, and a normal hepatic contour wouldn’t explain a mass lesion or capsule retraction.