Unusual sonographic appearance of a haemorrhagic biliary cyst

Abstract Diagnosis of simple biliary cyst is relatively easy when classic ultrasonographic features are preserved. Yet, not rarely, it may appear with atypical aspects making for a somewhat uncertain differential diagnosis with other cystic lesions. A case of intracystic haemorrhage with unusual sonographic features, closely mimicking biliary cystadenocarcinoma, is reported. Diagnostic imaging, which is useful in differentiating haemorrhagic biliary cyst from cystadenoma and cystadenocarcinoma, is also considered.