Newly detected hepatic lesions during surveillance in patients with a history of breast cancer are often suspected to represent metastatic disease; however, benign infectious conditions, including parasitic infections, may rarely mimic malignancy on imaging. A 48-year-old woman with a history of breast cancer who had undergone curative surgery was found to have a new hepatic lesion on routine surveillance imaging. Magnetic resonance imaging demonstrated a 1.1-cm irregular mass at the hepatic dome with peripheral enhancement, raising suspicion for metastasis. Laparoscopic wedge resection of the segment VIII lesion was performed for definitive diagnosis. Histopathologic examination revealed a necrotizing granuloma containing degenerated parasitic larvae with eosinophilic inflammatory infiltrates and no evidence of malignancy. The findings were most consistent with Capillaria hepatica infection, highlighting that parasitic necrotizing granuloma may be considered as a rare differential diagnosis in patients with prior malignancy.