J Korean Soc Radiol.  2014 Feb;70(2):133-136. 10.3348/jksr.2014.70.2.133.

Ultrasound and CT Findings of Primary Leiomyosarcoma in the Gallbladder: A Case Report

• Im AL
• Lee YH
• Yoon KH
• Lim SW
• Park DE
• Choi KH

• KMID: 1839422
• DOI: http://doi.org/10.3348/jksr.2014.70.2.133

Abstract

Leiomyosarcoma of the gallbladder is a very rare subgroup for gallbladder sarcoma. Herein, we report the ultrasound, computed tomography and positron emission tomography-computed tomography imaging findings on a case of primary leiomyosarcoma of the gallbladder. Abdominal ultrasonography indicates a heterogeneous hyperechoic submucosal mass with hypervascularity and displacement of overlying mucosal layers by the mass. Computed tomography reveal that the tumor is a well-defined and heterogeneously enhancing solid mass with overlying thick mucosal layers. Positron emission tomography-computed tomography visualizes the large gallbladder mass as a hypermetabolic lesion.

MeSH Terms

Electrons
Gallbladder*
Leiomyosarcoma*
Sarcoma
Ultrasonography*

Figure

• 

  Fig. 1 An 82-year-old male patient with incidentally detected GB mass on ultrasonography. A. Transabdominal ultrasonography demonstrates a large intraluminal protruding solid mass with heterogeneous echogenecity and thickened overlying echogenic mucosa (arrows). Hyperechoic hematoma is also shown beside the mass, within the GB lumen. B. Color Doppler ultrasonography reveals hypervascularity inside the mass. C. Noncontrast axial CT image shows hyperattenuating hematoma within the GB lumen (arrows). D. Coronal reformation image of contrast enhanced CT shows a large polypoid mass displacing the thick enhancing mucosal layer (arrow). It shows heterogeneous enhancement because of multiple necrotic and hemorrhagic foci. E. The GB mass is demonstrated as a marked hypermetabolic lesion on PET-CT image (SUV = 8.3). F. Gross pathologic specimen demonstrates a large well defined solid mass (★) arising from wall of the GB and thick overlying mucosal layer (arrows). This mass containes some necrotic and hemorrhagic foci. G. Photomicrograph (H&E stain, × 40) shows a leiomyosarcoma (★) of the GB, which is located below the mucosa as a single layer of columnar epithelium (black arrows) with an underlying lamina propria, irregular muscle layer, and loose perimuscular connective tissue (*). Note.-GB = gallbladder, PET-CT = positron emission tomography-CT, SUV = standardized uptake value

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