Focal multinodular hepatic steatosis: An uncommon presentation of a known entity

Hepatic steatosis is classified into several types according to its aetiology: metabolic; alcohol-related; metabolic with moderate alcohol consumption; associated with drugs or monogenic diseases, and cryptogenetic. An infrequent form of presentation is focal multinodular, and should be included in the differential diagnosis of solid liver lesions, which may simulate solid metastases. Magnetic resonance imaging is essential to identify the fat content and avoid unnecessary scans and invasive procedures such as biopsies. Focal multinodular hepatic steatosis is associated with vascular and metabolic risk factors, such as obesity, type 2 diabetes mellitus, and dyslipidemia. Treatment is based on modifying and controlling these underlying metabolic risk factors, with weight loss, a balanced diet, and regular physical activity being key strategies for lesion regression.