A 35-year-old woman is known to have focal nodular hyperplasia (FNH), with a 3.5 cm typical liver lesion detected on an MRI scan 10 years previously. She develops right upper quadrant pain. On updated MRI imaging, the lesion now measures 4.5 cm in segment IV. It is best seen after contrast, showing strong and homogeneous enhancement in the arterial phase and becomes iso-intense to the liver on the portal venous phase. No clear ‘central scar’ is seen. A biopsy is performed, which shows nodules of hepatocytes associated with fibrous septa.