Case presentation A 33-year-old man had fever for 2 months. He was admitted by the physician with the suspicion of pneumonia. However, both chest X-ray and computed tomography (CT) showed no abnormality. Tuberculosis and hematological and autoimmune diseases were all excluded. A giant hepatic lesion (20 cm) was detected by ultrasonography with the diagnosis of hemangioma. Contrast enhanced CT scan was conducted and hepatic hemangioma was confirmed. Some areas of the hepatic lesion had lower density compared to surrounding tissues and necrosis of the tumor was suspected. Treatment Right trisectionectomy was then performed and the symptom of fever disappeared after the operation. No bacteria grew in the culture of the necrosis tissue. Pathological examination confirmed the diagnosis of hemangioma and the necrosis. He was followed up for 5 months and no fever occurred.