Fig. 1

A 56-year-old male hospitalized for right upper abdominal pain with nausea and vomiting. The pain was irradiated to the right scapular region. His medical history included a total excision of dorsal melanoma 2 years before, with no evidence of metastatic disease at the primary staging. The B-mode US (a) showed the gallbladder lumen completely filled with heterogeneous content which was difficult to differentiate between tumefactive biliary sludge and parietal mass. The corresponding color-doppler (b) revealed no vascular signal within the endoluminal content. CEUS (c) demonstrated the vascularization of 2 polypoid lesions (arrows) protruding into the gallbladder lumen with intense contrast enhancement in the arterial phase (20 s). The portal venous phase CT images (d, e) confirmed two enhancing mural nodules (arrows) of galbladder wall that were histologically proved to be metastases from melanoma