This is a 65-year-old female with HCV cirrhosis that in the context of an US exploration due to unspecific abdominal pain is found with a liver mass of 4cm. The work up blood analysis shows a bilirubin of 2 mg/dL, alkaline phosphatase of 220 U/L, normal INR, and albumin of 34g/L. Abdominal and chest CT scan shows a liver mass in seg 4 of 3.5cm with atypical characteristics, LI-RADS-M, associated with a perihilar lymph node of 3cm in diameter, along with a lung nodule of 2cm. Biopsy is compatible with cholangiocarcinoma. Molecular study identified findings of FGFR2 fusions.