The patient willingly consented to partake in a study pertaining to solid tumors, which was duly registered in the China Clinical Trial Registry (ChiCTR2100052378), and an informed consent was duly obtained. MIP image of 68Ga-FAPI-04 PET/CT (A) showed a focus of abnormal 68Ga-FAPI-04 uptake in the upper abdomen (straight arrow) with increased 68Ga-FAPI-04 uptake in the parenchyma of the kidneys (curved arrows). IgA nephropathy is the leading cause of chronic kidney disease, which is commonly accompanied by glomerular fibrosis.1 Previous research has shown that 68Ga-FAPI-04 PET/CT imaging is a noninvasive and rapid way to assess renal fibrosis.2 On the axial image, a hypodense nodule with increased 68Ga-FAPI-04 uptake was seen in right lobe of the liver (straight arrows) (B, CT image; C, fused PET/CT image). Therefore, it was suspected to be intrahepatic cholangiocarcinoma. No metastases were found from vertex to thigh. The patient underwent partial right hepatectomy, and the mass was pathologically confirmed to be an intrahepatic arteriovenous malformation (AVM) with (D) CD34 (+) and (E) SMA (+). AVM is abnormal connections between veins and arteries that lead to blood flowing directly into veins.3 AVMs can occur anywhere in the body. Histologically, AVMs often exhibit both arterial and venous architecture, variable communication between vascular channels, and a lack of interposed capillaries as well as extensive fibrosis.4,5 We speculate that the high accumulation of 68Ga-FAPI-04 in AVM stems from the uptake by the activated fibroblasts. Meanwhile, an increasing number of case studies have reported 68Ga-FAPI-04 uptake in various nonmalignant etiologies, including myocardial infarction,6 IgG4-related disease,7,8 atherosclerotic plaque,9 xanthogranulomatous cholecystitis,10 tuberculosis,11 osteoarthritis,12 ankylosing spondylitis,13 and brucellosis.14 This case indicates that AVM should be considered as one of the differential diagnoses for abnormal 68Ga-FAPI-04 uptake in the liver.