Introduction : Tuberculosis is a disease of third world countries but infact no country is immune of it. This disease affects almost all parts of the body. Early recognition is very important. Liver rarely presents with tuberculosis. It has to be differentiated from non tuberculosis liver abscess and fibrolamellar variety of hepatocellular Carcinoma. If it is recognized early then it can be treated with medicine but some times it requires biopsy to confirm the disease. It usually presents with fever and weight loss.
In young age hepatic lesions may not be liver cancer and they should be differentiated from the non cancerous lesions

Methods : A 26 years old female was presented in emergency department for pain abdomen in the epigastric region. She had fever which was high grade for last few weeks. It was associated with off and on nausea and vomiting, Her lab tests were not significant but radiological reports confirmed lesions in the segment 5 and 6. It was found to be the liver tuberculosis after biopsy.

Results : Antituberculosis therapy for 9 months is very good for the treatment of liver tuberculosis if it is recognized early.

Conclusions : Many times hepatic lesions resembles the malignancy. In this case we had noticed that all the history and radiological investigations were in favour of fibrolamellar variety of hepatocellular carcinoma. In these cases probably liver biopsy play a vital role to manage the disease.