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Spontaneous combined internal and external biliary fistula is a very rare complication of biliary tract disease. Only two previous cases have been reported so far, and all of them with previous episodes of acute cholecystitis, treated without surgery. We describe a 27-year-old female patient (the younger reported to date) who presented with a long history of neglected gallbladder inflammation complicated by neuroglial implants on the peritoneum and on the gallbladder wall due to an ovarian teratoma. She had spontaneous cholecystocutaneous fistula and cholecystocolic fistula that were successfully treated by cholecystectomy and excision of the fistulous tract.