Dedifferentiated liposarcoma of the gallbladder: first reported case

Abstract

BackgroundLiposarcoma of the gallbladder is an extremely rare sarcoma, with only five cases reported in the literature according to our knowledge.Case presentationA 71-year-old woman was referred to the Surgical Oncology Division of Napoleão Laureano Hospital (João Pessoa, PB, Brazil) due to a solid mass at the right side of the abdomen and fever, with no signs of jaundice. Abdominal ultrasonography and computed tomography (CT) evidenced an extensive gallbladder lobular formation adhered to the inferior border of the right hepatic lobe and cholelithiasis. The CT report suggested gallbladder liposarcoma. A cholecystectomy associated with resection of segments IV-B and V of the liver were performed. Intraoperative frozen sections were compatible with gallbladder sarcoma. Anatomopathological examination and immunohistochemistry confirmed dedifferentiated liposarcoma with foci of heterologous leiomyosarcomatous differentiation and undifferentiated fusocellular areas of high histological grade.ConclusionThis is the first case of dedifferentiated liposarcoma of the gallbladder to be reported.

Primary spindle cell sarcoma of gallbladder

“…Gallstones are invariably present in several types of primary sarcomas of the gallbladder (Tables 1 and 2), and the presenting symptoms are those of chronic cholecystitis. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] In this series of 65 cases reviewed in the literature, no case was correctly diagnosed before surgery, except when it was preoperatively diagnosed by biopsy. CT and MRI are considered to be the best diagnostic techniques for cancer staging and surgical strategy guidance.…”

“…A variety of tumors composed of sarcomatous elements include carcinosarcoma and 11 types of primary sarcoma (extraskeletal osteosarcoma, Langerhans cell sarcoma, synovial cell sarcoma, rhabdomyosarcoma, malignant fibrous histiocytoma variants, leiomyosarcoma, angiosarcoma, neurofibrosarcoma, myogenous sarcoma, and liposarcoma) (Tables 1 and 2). To date, there have been 65 cases reported in English outlets [4–22] Table 1. presents the results.…”

Liposarcoma of gallbladder: a case report and literature review

“…Sarcoma of gallbladder is a rare clinical entity, and a PubMed search using key words of gallbladder and sarcoma identified 46 reported cases in past two decades [ 2 , 4–7 ] ( Table 1 ). The histopathological types of sarcoma were as shown in Table 1 , and leiomyosarcoma and malignant fibrous histiocytoma variants were the most common subtype (35% for each) and liposarcoma represented for 11% of gallbladder sarcoma.…”

“…In terms of long-term outcomes, the patients with low-grade myxoid and well-differentiated subtypes have excellent outcomes with survival rate greater than 90% at 5 years after complete resection [ 4 , 9 , 10 ]. Chemotherapy should be reserved for unresectable disease and adjuvant therapy after complete resection is not recommended.…”

Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gallbladder: A Systematic Review of Outcomes Following Surgical Management

“…Malignant tumors of the gallbladder are rarely encountered (1). Notwithstanding the fact that the gallbladder has a somewhat uncomplicated histological structure, a plethora of malignant lesions have been reported to arise from the gallbladder such as papillary and mucinous adenocarcinomas, squamous cell cancers, sarcomas and neuroendocrine tumors (1)(2)(3)(4). Papillary adenocarcinoma is the most dominant histologic subtype accounting for approximately 98% of all gallbladder malignant tumors, while neuroendocrine tumors on the other hand are substantially uncommon accounting for a mere 0.5% (1,5).…”