Summary The case history of a 62-year-old woman with progressive jaundice is presented. To our knowledge, this is the third patient reported in the literature with a leiomyosarcoma of the common duct. Preoperative diagnostic difficulty arose because of a history of chlorpromazine ingestion 1 week before the onset of jaundice. Other sar comas reported to arise in the bile ducts include melanosarcoma, round cell sarcoma, and sarcoma botryoides, which is a form of embryonal rhabdomyosarcoma occurring predominantly in infants and children.