Primary Leiomyosarcoma of the Gallbladder

Leiomyosarcoma (LMS) of the gallbladder is an extremely rare entity. Most reported cases were mistakenly diagnosedpreoperatively as cholecystitis with or without cholelithiasis. We believe that our article demonstrates the 5thcase of gallbladderLMS that was suspected preoperatively to be malignant rather than cholecystitis, which fortunately led to radical resection of thetumor instead of simple cholecystectomy. However, the definitive diagnosis relies exclusively on histological andimmunohistochemical techniques. We present a case of a 62-year-old Caucasian female complaining of signs and symptomssuggestive for cholecystitis. On ultrasonography, the gallbladder appeared enlarged andfilled with a necrotic mass; thus, thepresence of adenocarcinoma was suspected. Multislice Computerized Tomography (MSCT) demonstrated no distant metastasis.An extensive radical cholecystectomy was performed, and histological techniques confirmed a leiomyosarcoma diagnosis. Inaddition, adjuvant chemotherapy of doxorubicin and ifosfamide was administrated. The patient was on follow-up for 2 yearsand is doing well till date. The discrimination of gallbladder sarcoma preoperatively remains a clinical and radiologicalchallenge. Although radical resection of the tumor remains the mainstay of the treatment, we believe that adjuvantchemotherapy should be administrated in such cases. However, further studies are required in thisfield