Nontraumatic liver herniation mimicking a right lower lobe lung mass

Nontraumatic liver herniation through diaphragm is a rare condition. We present a case of a 54-year-old female presenting with nontraumatic liver herniation mimicking a right lower lobe mass. Patient was noted to have growth of two right lower lobe lung nodules from 1.5 cm × 2.8 cm and 0.9 cm × 1.3 in August 2009 to 2.8 cm × 4.1 cm and 1.1 cm × 1.4 cm in March 2019 on computerized tomography (CT) scan. PET scan as well as the growth pattern was consistent with low-grade malignancy likely carcinoid tumor. CT-guided biopsy was not feasible because of location of the mass. We performed robotic thoracoscopy with plan for wedge resection, however gross inspection of the thoracic cavity revealed two masses on the dome of the diaphragm with appearance like liver and correlating with nodules seen on CT scan. A core needle biopsy showed that it was benign liver tissue.