Bile duct adenomas (BDAs) are benign intrahepatic biliary proliferations consisting of bile ducts arranged in small and tortuous tubules and embedded in a dense fibrous stroma 1. Microscopically, tubules are lined by a single layer of cuboidal to columnar cells with nuclei showing neither atypia nor mitoses. BDAs were formerly considered reactive by some authors 2,3. Recurrent BRAF V600E mutations were however further identified in these lesions, supporting the hypothesis that they are true neoplasms 4,5. They are most often incidentally identified during intra-abdominal surgery and the main differential diagnosis of BDAs is metastatic adenocarcinoma, as mentioned by Levin et al. in the first report of bile duct adenomatosis of the liver 6.