A 57 year old female presented to the surgical oncology clinic with symptoms of severe, sharp right upper quadrant pain extending to her right shoulder. Her medical history was uncomplicated other than a BMI of 38 and she had a history of significant tobacco use. She had a benign exam and unremarkable labs. Imaging revealed a giant right hepatic complex cystic mass. After comprehensive work up, the complex cyst was resected laparoscopically. Great care was taken to avoid injury to the inferior vena cava and right hepatic vein. Frozen and routine pathology returned benign, simple right hepatic cyst containing blood and pigment laden macrophages without organisms or parasites. The patient discharged home on post operative day one. She returned for follow up in clinic without complaint and was instructed to follow up as needed.