Background: The liver is a parenchymatous organ which is a host to a wide variety of focal lesions, and the advent of ultrasound largely contributed to an increase in their detection. The first diagnostic challenge is to differentiate between benign and malignant tumours, and the next task is accurate recognition of pathomorphological structure of the mass. Case reports: In this paper we present patients with infrequently occurring focal liver lesions, including focal nodular hyperplasia, peripheral cholangiocarcinoma, fibrolamellar cancer, unusual haemangioma, hydatid cyst and hepatic abscess. These case reports serve as a background for presentation of diagnostic dilemmas. Conclusions: Although many diagnostic algorithms have been proposed for patients with focal liver disease, consulting hepatologists frequently face incompatible or apparently contradictory laboratory, radiological and cytological data in patients with rare or atypical hepatic tumours.