A 45-year-old male patient, a driver from Xiangyang, Hubei, presented to Xiangyang Hospital of Traditional Chinese Medicine on July 9, 2023, with a “liver mass detected for more than 4 days”. Upper abdominal MRI revealed a huge cystic lesion in the right lobe of the liver, with T1 long/T2 slightly long signal intensity on MRI. The DWI shows a slightly hyperintense signal, with dimensions of approximately 139 mm × 119 mm × 147 mm. Multiple small cysts were visible within the lesion, arranged in a wheel-like pattern around the periphery. Immunoserological testing of the patient’s venous blood showed positive IgG antibodies against Echinococcus. On July 15, a partial hepatectomy was performed. The resected mass was cystic, grayish-white and measured 160 mm × 150 mm × 150 mm in size. The contents of the mass were a pale yellow, clear liquid, with varying-sized cystic cavities inside. Pathological examination of the mass revealed a cyst wall thickness of approximately 1 mm with multiple protoscoleces present. The patient had served in the military in Xizang from 1996 to 1999, during which time he had a history of contact with cattle and sheep feces, as well as a history of drinking unboiled water or consuming food in the wild. Based on the epidemiological investigation, clinical data, and relevant examination results, the patient was ultimately diagnosed with imported hepatic alveolar echinococcosis from Xizang, with an incubation period of up to 25 years. The patient recovered well after surgery and was discharged one week later. Upon discharge, the patient was instructed to take albendazole orally (15 mg/kg per day). Two weeks after surgery, the patient reported no significant discomfort.