Fibrolamellar hepatocellular carcinoma (FLH) is a rare variant of hepatocellular carcinoma that typically occurs in adolescents or young subjects in an otherwise normal liver. Correct recognition of FLH is extremely important, because a complete resection of the tumor can confer an excellent prognosis. FLHs can become large, exerting mass effects on adjacent organs before diagnosis. Unfortunately, there are very few imaging reports describing external compression of the stomach caused by a FLH. We report the case of a young female suffering from dyspepsia and abdominal pain caused by stomach compression resulting from a large FLH.