Presentation
Painless jaundice and fatigue.
Patient Data

Axial CT demonstrated intrahepatic biliary ductal dilatation. There is an ill-defined area of hypoattenuation within the central aspect of the liver near the confluence of the right and left hepatic ducts. Additionally, a 1.2 cm mass is present within the right hepatic dome. There is associated retraction of the liver capsule.
Bilateral adrenal nodules are present measuring 1.8 cm on the right and 0.9 cm on the left.
Case Discussion
Cholangiocarcinoma often presents late in disease course after metastatic spread has occurred. Metastasis to the adrenal glands is common and identifying such a metastatic lesion radiologically is significant to inform clinicians of disease severity.