Gall bladder carcinoma: Aggressive malignancy with protean loco-regional and distant spread

Figure 8 Gallbladder carcinoma: regional and distant metastasis. A: Axial contrast-enhanced computed tomography abdominal section shows heterogenous mass lesion involving fundus of gall bladder fossa (arrow) with associated circumferential enhancing wall thickening of CBD (dashed arrow) indicating cholangitis or intraductal spread of malignancy; B: Axial CECT abdominal section shows hypodense filling defect in left branch of portal vein indicating thrombus formation (arrow). Hepatic infiltration is seen in segment VII (yellow arrow) with retroperitoneal lymph nodal metastasis (dashed arrow); C: MIP axial CT imaging shows soft tissue nodule in anterior segment of right lung indicating pulmonary metastasis (arrow); D and E: Sagittal and coronal CECT abdominal sections (bone window) show multiple osteoblastic skeletal metastatic lesions. CBD: Corticobasal degeneration; CECT: Contrast-enhanced computed tomography.