COLLISION TUMOUR: ADENOCARCINOMA OF GALLBLADDER WITH LEIOMYOSARCOMA

Collision tumours, characterized by the synchronous growth of two distinct tumour types, are exceedingly rare. This report presents a case of a collision tumour involving adenocarcinoma of the gallbladder and leiomyosarcoma. A 75-year-old male presented with a 4-day history of vomiting, persistent hiccups, fever, and right upper abdominal pain. Physical examination revealed abdominal distension, tenderness, and positive Murphy’s sign, with localized tenderness in the right hypochondrium. Ultrasound performed prior to admission identified multiple echogenic gallbladder calculi. Contrast-enhanced CT of the abdomen showed moderate ascites, multiple large radiopaque calculi, and bilateral mild perinephric fat stranding. During laparotomy, dense adhesions, necrotic tissue surrounding the gallbladder, and nodules on the omentum were observed. A subtotal cholecystectomy was performed. Histopathological examination revealed a well-differentiated adenocarcinoma of the gallbladder infiltrating all layers, along with leiomyosarcoma involving the omental nodules. This case underscores the rare coexistence of two distinct malignancies within a single clinical presentation, highlighting the importance of thorough histopathological evaluation in similar scenarios.