Xanthogranulomatous cholecystitis (XGC) is a rare disease, affecting 0.7–13.2 % of patients with cholecystitis [1]. It can be mistaken for thickened-wall gallbladder carcinoma (GBC). XGC presents diverse imaging features due to inflammatory infiltration and fibrosis, resulting in uneven gallbladder wall thickening, often involving surrounding organs and collectively mimicking malignancy [2]. This makes preoperative identification challenging [3]. While fine needle aspiration is the gold standard…