Background: A 62-year-old male with no medical history underwent an ultrasonography of the abdomen because of changed bowel habits and abdominal pain. CT-scan of the abdomen was performed, which initially suggested liver metastases. However, no primary tumor could be identified. Further work-up comprised optical colonoscopy which showed diverticulosis but no evidence of malignancy. Tumor markers were within normal limits. US-guided biopsy revealed normal liver parenchyma but the representativity of the biopsy was questioned. PET-CT scan was planned and a new biopsy was requested, but after interdisciplinary discussion it was decided to perform MRI of the liver first.