Solution: Hepatic adenomas are a rare benign lesion of the liver that has two subtypes. Those of bile duct origin (which are typically small and clinically insignificant) and those of liver cell origin which are larger and can be clinically relevant. They are made up of well differentiated hepatocytes without Kupfer cells (thus, they do not take up sulphur colloid) or bile ducts. Incidence is increase in women on oral contraceptives, as well as patients with glycogen storage disease, diabetes mellitus, hemochromatosis, or acromegaly, and males using anabolic steroids. The primary risks are those related to rupture and hemorrhage, as well as a low risk of malignant transformation to HCC. As a result of these risks, if they do not respond to discontinuation of the oral contraceptives, they are often removed surgically. They are difficult to differentiate from HCC on imaging alone and clinical information and biopsy can be helpful for definitive diagnosis. Of note, this patient also has a fatty liver.