An 81-year-old woman with a history of colitis, hiatal hernia and depression reported abdominal pain, bilious vomiting and absence of transit for 7 days.
CT showed a liver mass in segments IV-V probably related to gallbladder carcinoma with caudal extension and non-causal angle of the first duodenal portion and hepatic angle of the colon, causing obstructive symptoms.
A double derivation (gastrojejunostomy and ileotransversostomy) and liver mass biopsy were performed.
The patient died 7 days later due to multiple organ failure.
Pathology showed a fusiform cell tumor with low mitotic activity, which after ultrastructural examination and IHC was diagnosed as leiomyosarcoma of the gallbladder.
