Leiomyosarcoma of the gallbladder: A case report

Primary sarcoma of the gallbladder is a rare disease. The tumor occurs more frequently in women. Usually gallstones are present. Symptoms resemble tho se of cholelithiasis or cholecystitis. The diagnosis is rarely made preoper atively. The patient was a 51-year-old woman with a 2-month history of righ t upper quadrant pain, nausea, vomiting, and a 10-pound weight loss. Ultras ound showed cholelithiasis and cholecystitis. Laparoscopic cholecystectomy was converted to open as a result of dense tissue in the middle to distal g allbladder. Exploration by a right subcostal incision revealed multiple imp lants on the surface of the liver and the peritoneum of the upper abdomen. The wall of the gallbladder was very thick and inflamed. Cholecystectomy wi th liver biopsy was performed. Pathology revealed poorly differentiated epi thelioid leiomyosarcoma of the gallbladder with extension to the liver. The disease followed a very aggressive course and the patient died 3 weeks aft er the procedure. Recommended treatment is extensive surgical resection tha t can be followed by radiotherapy or chemotherapy. The tumor follows a very aggressive course, which often lasts a few weeks. Prognosis is poor with r are reported 5-year survivals.