A 54-year-old male with no subjective complaints was admitted to our hospital with fatty liver and low echoic lesion of 3 X 4 cm, thereafter revealed to be a hemangioma. A white lesion of few millimeters in size was detected in the left lobe of the liver at laparoscopic examination, and histologically diagnosed in an aimed biopsy as cholangiocarcinoma. Another 5 lesions (three white spots, a white longitudinal protrusion and a white lesion with a lacy pattern) suggestive of malignancy were also selectively biopsied, but all proved histologically negative. Microwave coagulation was applied to all biopsied sites as anti-cancer therapy.