We report two cases of unusual hepatic lesions following years of monotherapy with pyridylcarbinol (timespan) in a daily dose of 1.35 to 1.5 g for familial hypercholesterolemia. Mild elevations of liver enzymes correlated to a large tumor-like mass in the gallbladder region in one case and nodular changes in the whole liver (diagnosed by ultrasound) similar to metastatic lesions. After discontinuation of pyridylcarbinol the changes in the liver regressed markedly in both cases.