AN AUTOPSY CASE OF GRANULOCYTIC SARCOMA OF THE PORTA-HEPATIS CAUSING OBSTRUCTIVE-JAUNDICE

We describe an extremely rare case of granulocytic sarcoma of the port a hepatis causing obstructive jaundice. The patient was an 84-year-old man admitted because of obstructive jaundice. Ultrasonography (US) an d computed tomography (CT) scanning of the abdomen disclosed a mass ab out 2.5 cm in diameter near the neck of the gallbladder, and thickenin g of the gallbladder wall. Based on these findings, gallbladder carcin oma was suspected. After endoscopic retrograde biliary drainage (ERBD) was performed, the jaundice resolved. However, blast cells were detec ted in the peripheral blood 51 days after admission, and laboratory st udies disclosed acute myelocytic leukemia (AML: French-American-Britis h [FAB] type M0). We treated him conservatively, with antibiotics and ERBD but he died of disseminated intravascular coagulation. Autopsy sh owed that the suspected gallbladder carcinoma was actually a granulocy tic sarcoma arising in association with AML and causing obstructive ja undice. The largest tumor involved the porta hepatis. IL should be kep t in mind that granuloctyic sarcoma is a possible cause of obstructive jaundice, even in patients with no evidence of AML.