Primary clear cell carcinoma of the liver (PCCCL) is a rare hepatocellular carcinoma (HCC) subtype with distinct imaging features such as low-density lesions on CT and equal signal intensity on MRI, often mimicking other hepatic tumors. Fibrolamellar hepatocellular carcinoma (FL-HCC) predominantly affects adolescents without chronic liver diseases, presenting as a large mass with central fibrous scars and calcifications, and generally exhibits a better prognosis than typical HCC. Scirrhous hepatocellular carcinoma (SHCC) is characterized by significant fibrosis, presenting as a hard, white or light yellow mass with diverse imaging enhancement patterns, and generally demonstrates higher overall survival rates compared to ordinary HCC. Primary hepatic carcinosarcoma (PHCS) is an extremely rare and aggressive tumor featuring both carcinomatous and sarcomatous components, prevalent in older males with a history of hepatitis or cirrhosis, and has a very poor prognosis. Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) consists of mixed regions of HCC and cholangiocarcinoma, with variable imaging features and a generally poor prognosis. Differential diagnosis across these subtypes is challenging due to overlapping clinical and imaging features, but unique histopathological markers and imaging characteristics aid in accurate identification.