DOI: https://doi.org/10.36347/sjmcr.2025.v13i12.026

Pages: 2994-2997

Xanthogranulomatous cholecystitis (XGC) is an uncommon, benign but locally invasive inflammatory disorder of the gallbladder that may closely resemble gallbladder cancer in clinical and radiographic evaluations. Although the majority of XGC cases are limited to the gallbladder, contiguous inflammatory expansion leading to hepatic abscess development is an infrequent, although potentially severe, consequence. We report the case of a 90-year-old male who had right upper quadrant stomach discomfort and fever, with imaging indicating a significantly thickened, dilated gallbladder and a massive, multiloculated hepatic abscess, suggesting direct inflammatory extension. The patient was well treated with percutaneous abscess drainage followed by laparoscopic cholecystectomy, which confirmed histopathologically the presence of XGC without cancer. This case emphasizes the clinical and diagnostic difficulties associated with XGC, including uncommon liver involvement, and shows the need to identify such complications for effective care.