CT
Multiple hepatic lesions occupying segments 4, 5, 6 and 8. The largest lesion in segment 6 measures 70 x 60 mm. The gallbladder is distended with areas of abnormal soft tissue density within it. Hyperdense lesion in the upper pole of the spleen.
Features favouring a gallbladder adenocarcinoma with multiple hepatic metastases. Multifocal hepatocellular carcinoma and metastatic deposit in the spleen are within the differential.