Simple Hepatic Cyst: This is the most common benign liver lesion, often asymptomatic and discovered incidentally. Multilocular appearance can occur due to the presence of multiple simple cysts or septations within a larger cyst.

Polycystic Liver Disease (PLD): Characterized by the presence of multiple cysts scattered throughout the liver, often associated with polycystic kidney disease. The cysts can be variable in size and may cause liver enlargement.
Cystic Hepatocellular Carcinoma or Metastasis: Although less common, primary or metastatic malignancies can present as multilocular cystic lesions due to necrosis or cystic degeneration within the tumor.
Biliary Cystadenoma/Cystadenocarcinoma: These are rare, benign or malignant tumors of the biliary epithelium, which can present as multilocular cystic masses. They often contain mucinous fluid and may have a characteristic ovarian-like stroma in the case of cystadenomas.

Hydatid Cyst (Echinococcosis): Caused by the parasitic infection Echinococcus granulosus, these cysts can appear as multilocular lesions due to the formation of daughter cysts within the larger cyst. Infection can lead to significant morbidity if not treated.
Amebic Liver Abscess: Although typically unilocular, amebic liver abscesses can appear multilocular in rare cases. They are a serious condition that requires prompt diagnosis and treatment to prevent complications like rupture or spread of infection.

Mesenchymal Hamartoma: A rare, benign tumor of the liver that can present in childhood, often containing cystic components along with solid elements.
Ciliated Foregut Cyst: A rare, congenital anomaly that can appear as a cystic lesion in the liver, lined by ciliated pseudostratified columnar epithelium.
Intrahepatic Biliary Papillomatosis: A rare condition characterized by multiple, recurrent, and potentially malignant biliary papillomas that can cause multilocular cystic dilatation of the intrahepatic bile ducts.