A 79-year-old man with a history of diabetes mellitus and chronic atrial fibrillation complaining of pain in the right hypochondrium radiating to the lumbar region associated with a constitutional syndrome of one month evolution.
Abdominal computed tomography (CT) performed due to poor outcome with empirical antibiotic treatment for suspected urinary infection showed a distended gallbladder with perivesicular abscess in close contact with the liver.
Therefore, it was decided to perform CT-guided puncture and drainage, after which the patient presented a compatible picture of septic shock.
The patient underwent surgery, finding a tumor compatible with neoplasia, pathological lymph nodes in the hepatic hilium and multiple metastatic lesions in the liver parenchyma, dying 24 hours later in multiple organ failure.
Pathology showed a fusiform cell tumor that, after ultrastructural and immunohistochemical examination (IHC), was diagnosed as leiomyosarcoma of the gallbladder.
