Solution: Ciliated hepatic foregut cysts are epithelial lined hepatic cysts within the liver. They are being diagnosed with increasing frequency as people become more aware of this entity. They characteristically are located in Segment IV, close to the falciform ligament, are unilocular, subcapsular and relatively small, measuring less than 3 cm on average. They are generally asymptomatic, but can be associated with RUQ pain. They are known to occasionally undergo malignant transformation to a squamous carcinoma. The imaging alone is not necessarily diagnostic, but should be considered if the above imaging findings are identified. Biopsy/aspiration shows ciliated columnar cells, but sensitivity is not high. Should consider surgical resection if they become large or symptomatic because of the risk for malignant transformation, which is often associated with a very bad outcome (but fortunately is uncommon).