Gallbladder sarcomas are exceedingly rare, with a global reported incidence of merely 65 cases documented in the literature

Introduction:

A 45-year-old female patient presented with a two-month history of progressively increasing abdominal distention and a palpable lump. Initial evaluation at a prominent cancer hospital in Gujarat led to a diagnosis of gastrointestinal sarcoma, most likely originating from the gall bladder. Subsequently, the patient was referred to Rama Hospital & Research Centre, Lakhanpur, Kanpur, for further comprehensive management.

Clinical Presentation:

The patient's abdominal distention had escalated, resulting in respiratory distress, loss of appetite, and a deteriorating overall condition. The physical examination revealed a sizable mass measuring 30 x 30 x 15 cm, spanning from the right hypochondrial region to the right iliac region, with medial extension up to the midline. The mass exhibited mobility, firm consistency, and ill-defined borders, without tenderness.

Diagnostic and Therapeutic Approach:

Following a multidisciplinary tumour board consultation, a triple-phase CT scan was conducted, informing the decision to proceed with surgical intervention. Intraoperatively, a mass measuring 25 x 15 x 30 cm was observed, arising from the gall bladder and involving adjacent structures, including the liver surface, mesentery of the ascending colon, omentum, and peritoneal nodules within the right paracolic gutter. Additionally, metastatic lesions were identified in the right ovary. A meticulous R0 resection was performed, encompassing en bloc resection of the mass, cholecystectomy, liver wedge resection, right hemicolectomy, right peritonectomy, omentectomy, and right salpingo-oophorectomy. The procedure culminated with the creation of a distal ileostomy.

Postoperative Care and Outcome:

The patient's postoperative course necessitated close monitoring in the intensive care unit, including ventilator support and ionotropic assistance. She exhibited a favorable recovery trajectory and is now poised for discharge, having achieved satisfactory recuperation.

Discussion:

Gallbladder sarcomas are exceedingly rare, with a global reported incidence of merely 65 cases documented in the literature. The present case underscores the significance of collaborative efforts in achieving a positive outcome for patients with such challenging malignancies.

Rama Hospital & Research Centre, has demonstrated its commitment to providing exceptional healthcare services through its pivotal role in successfully managing this complex case. The hospital's multidisciplinary approach, state-of-the-art facilities, and dedicated medical professionals, including Dr. Kush Pathak, Dr. Archana Marzi, Dr. Roshin Philip, Dr. S.K. Gahlot, and Dr. Neha, have collectively contributed to the patient's remarkable recovery. Rama Hospital's consistent dedication to advanced patient care positions it as a cornerstone in delivering high-quality healthcare services to the community.

In conclusion, the successful management of this rare gallbladder sarcoma exemplifies the power of interdisciplinary collaboration and timely intervention, ultimately salvaging a patient who otherwise faced dire circumstances under the expert care of Rama Hospital & Research Centre.