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Primary hepatic adenosquamous carcinoma (ASC), a variant cholangiocellular carcinoma (CCC) subtype, is rare with very poor prognosis. It is difficult to diagnosis only with a serum marker and imaging study. We reported a case of primary hepatic ASC presenting with abdominal discomfort and fever. According to clinical features and imaging studies, liver abscess was diagnosed initially. After further evaluation, hepatic tumor with peritoneal carcinomatosis was suspected; biopsy of the hepatic tumor revealed carcinoma with both glandular and squamous differentiation, findings compatible with ASC. Because no other primary site was found for malignancy, primary hepatic ACS with peritoneal carcinomatosis was diagnosed. This patient succumbed from multiple organ failure 1 month after the diagnosis.