Abstract
A 71-year-old woman presented to the emergency room of an academic hospital for biliary vomit of one week duration. Her past medical history was remarkable for a recurrent atypical meningeal neoplasia, diagnosed ten years earlier, treated with surgical excision and radiotherapy in 2008, then only with radiotherapy in2013, 2015, 2017. Blood tests revealed increased serum gamma-glutamyltransferase and alkaline phosphatase. At physical examination, hepatomegaly was noted; abdominal ultrasound revealed multiple inhomogeneous hypo-echoic hepatic lesions (the largest 11 cm in diameter).
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