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

Primary leiomyosarcoma of gallbladder

Affiliations
  • 1Department of Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. seohi71@hanmail.net
  • 2Department of Radiology, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3Department of Pathology, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

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

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

  • 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).

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

  • 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.

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

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


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