A 23 -year-old primigravida, at 28 weeks of gestation, presented with pain in the right hypochondrium for the one-month duration without any other associated symptoms. The ultrasonography (USG) of the abdomen revealed a large heterogeneous, hyperechoic lesion in the right lobe of the liver. On magnetic resonance imaging (MRI) of the abdomen, there was a well-encapsulated exophytic mass lesion from segments II, IV, and V of size 11.6 x14 1x10 2centimeters (anterior-posterior X craniocaudal X transverse) with a large central scar. This scar was hypointense on the T1 weighted sequence and showed heterogeneous hyperintensity on T2 weighted sequence (figure 1 a&b). The diffusion-weighted imaging (DWI) showed a hyperintense signal along the periphery on high B value images with the corresponding intermediate to low apparent diffusion coefficient (ADC) values. The central scar showed high ADC values. There was no signal drop on in-phase or opposed phases. Her blood workup showed alpha feta protein (AFP) of 117.8 ng/ml and serum alkaline phosphatase of 209 U/L with normal liver and renal function tests. The antenatal scan showed a live viable fetus with a gestational age of 28 weeks. With the patient and her family being an active part in the decision-making, the decision to undergo surgery was made at the multidisciplinary tumor (MDT) board meeting. She was started on tocolytics, and all precautions were taken for emergency termination of pregnancy if required. She underwent non-anatomical resection of the liver containing tumor with a minimum one-centimeter gross margin. The fetal monitoring was done throughout her stay in the hospital. She had an uneventful recovery. Histopathological examination (HPE) showed an infiltrating lesion in the liver with large areas of necrosis and hemorrhage (figure 2 a-d). The cells were arranged in sheets and showed bizarre giant cells with frequent atypical mitosis. Some of the giant cells resembled syncytiotrophoblasts. The adjacent liver parenchyma was unremarkable. The tumor was immuno-negative for hepatocyte specific antigen (HSA), Arginase, and Glypican-3, ruling out primary hepatocellular carcinoma (HCC). However, the tumor cells showed intense immune expression for Sal-like protein 4 (SALL-4), Placental alkaline phosphatase (PLAP), and Beta-human chorionic gonadotrophin (HCG), confirming the diagnosis of choriocarcinoma (figure 3 a-f). The histopathology and additional immunohistochemical (IHC) stains (CD30, D2-40, CD117) did not reveal any other type of germ cell tumor, and it was diagnosed only as PHC. The patient was again discussed in MDT and planned for early elective termination of pregnancy. So elective cesarean section was done at 32 weeks of gestation. The premature baby succumbed to respiratory distress on the second day. The post-delivery beta HCG levels were 11,875 IU/ml and 105 ng/ml AFP. The HPE of the placenta showed no evidence of choriocarcinoma. In metastatic workup, a positron emission tomography (PET) scan showed multiple scattered bi-lobar hepatic metastasis and pulmonary, presacral, rectal, and iliac nodal metastasis, and no tumor was present in any gonadal site (figure 4 a&b). She is currently undergoing chemotherapy with Etoposide, Methotrexate, Actinomycin D, and Cisplatin (EMA-EP regimen). The patient is currently doing well and under regular follow-up four months after the primary surgery.