Adenosquamous carcinoma of the gallbladder with multiple cystic liver metastases showing fluid levels on MR images

A 82-year-old male with fever of 38.4 °C was referred to our institution for the evaluation of a hepatic mass. The abdominal ultrasound and dynamic CT revealed a huge mass of the gallbladder with cystic changes that was considered to be a gallbladder carcinoma. The dynamic CT and MRI also showed multiple intrahepatic tumors that showed completely cystic lesions with fluid–fluid levels. Since the patient had fever, the blood test results suggested inflammation, and hepatic abscesses could not be ruled out for the cystic lesions. The multiple cystic lesions were confirmed to be cystic metastases with intratumoral hemorrhage pathologically, and there were no inflammatory reactions around the lesions.