Cyclist: slightly foxed.

Abnormal liver function tests (LFTs) are a common cause for referral to hepatology outpatient departments. Cross-sectional imaging may reveal a liver lesion. We report the case of a 33-year-old man who presented with abdominal pain and deranged LFTs and was found to have a large liver cyst on ultrasound scanning. Specific Echinococcus multilocularis serology testing was positive and he underwent triple phase CT, MRI and positron emission tomography-CT to further characterise the lesion. He was treated with long-term albendazole with subsequent improvement in symptoms, blood results and cyst size on follow-up imaging.