J Korean Surg Soc.  2012 Dec;83(6):403-407. 10.4174/jkss.2012.83.6.403.

Primary leiomyosarcoma of gallbladder

• Park EY
• Seo HI
• Yun SP
• Kim S
• Kim JY
• Han KT

• KMID: 1437544
• DOI: http://doi.org/10.4174/jkss.2012.83.6.403

Abstract

Malignant mesenchymalneoplasms of the gallbladder are extremely rare with only 105 cases of primary gallbladder sarcoma having been described. It has a very aggressive behavior and is usually diagnosed at advanced stages. Therefore, curative surgical management may not be possible. We performed a radical cholecystectomy (S4b + S5 segmentectomy), omentectomy and small bowel resection in a 54-year-old patient with locally invasive leiomyosarcoma of the gallbladder. Further studies are needed to confirm the benefit of aggressive treatment for patients with leiomyosarcoma of the gallbladder.

Keyword

Leiomyosarcoma; Gallbladder neoplasms

MeSH Terms

Cholecystectomy
Gallbladder
Gallbladder Neoplasms
Humans
Leiomyosarcoma
Middle Aged
Sarcoma

Figure

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  Fig. 1 Endoscopic ultrasound shows 6.7 × 7.1 cm-sized huge mass on gallbladder body extended to omentum but not invaded into duodenum.

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  Fig. 2 Computed tomography (CT) image with intravenous contrast shows 9 cm-sized exophytic gallbladder mass that invaded abdominal wall (A, thick arrow) and small bowel (B, thin arrow).

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  Fig. 3 Coronal T2WI shows 9 cm-sized well-defined and heterogenousexophytic mass lesion in gallbladderaccompanied by invasion into surrounding tissues.

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  Fig. 4 A hypermetabolic lesion (maximum standardized uptake value [SUVmax] 14.5) in entire gallbladder was shown on 18F-fluorodeoxyglucose positron emission tomography/computed tomography.

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  Fig. 5 Higher magnification of spindle cell component displaying marked nuclear atypia and mitosis (62/10 high-power fields [HPFs]; H&E, ×400).

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  Fig. 6 (A) Tumor cells showed positive immunoreactivity for smooth muscle actin (A, ×200) and vimentin (B, ×400).

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