A 73-year-old woman was admitted with the chief complaint of abdominal pain. Computed tomography suggested malignant tumor of the gallbladder infiltrating the liver, duodenum, and transverse colon. Extended cholecystectomy with en bloc resection of the involved liver, transverse colon, and duodenum was performed to achieve curative resection. Pathologic evaluation led to the diagnosis of stage IVA squamous cell carcinoma (T4aN0M0), according to the biliary tract cancer classification established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Hepatic hilar lymph node recurrence was identified 3 months later and heavy ion radiotherapy was performed. The patient was hospitalized after 8 months with acute cholangitis, which improved with conservative treatment;however, heart failure worsened during treatment and she died 9 months after surgery.