Primary sarcoma of the gallbladder is a very uncommon neoplasm.' This tumor is rarely diagnosed preoperatively. In 1978, Olken reported a case of a gallbladder carcinoma which was diagnosed by preoperative ultrasonography .' We have performed real-time B-mode ultrasonography in a patient with primary leiomyosarcoma of the gallbladder. To our knowledge, this constitutes the first recorded instance of the use of ultrasonography to identify a primary sarcoma of the gallbladder.
REPORT OF A CASE
A 69-year-old woman was admitted to the hospital in December 1982 with right upper quadrant abdominal pain. The pain was continuous and began 5 months prior to admission. The patient also complained of abdominal distension, occasional nausea and a 2-kg weight loss. On physical examination, a firm mass of rubbery consistency, approximately 8 cm in diameter was felt in the rifl;ht upper quadrant of the abdomen. There was moderate tenderness on palpation of the mass. Laboratory examination showed a hemoglobin of 12.1 g/lOO ml, hematocrit of 40%, and a white blood count of 12.300/cu mm (basophils 2, eosinophils 2, monocytes 2, lymphocytes 19, bands 2, segmented 73). The alkaline phosphatase, bilirubin, SGOT and SGPT were normal.
A plain abdominal film showed a radiopaque stone in the right upper quadrant. An upper gastrointestinal series was normal. The gallbladder was not visualized in a double dose oral cholecys-From the Departments of Surgery and Pathology of the Fed-