Gonadal vein leiomyosarcoma: A case report with radiological findings

Leiomyosarcoma of the Right Gonadal Vein: Review of the Approach and Prognostic in a Rare Case

“…A venous leiomyosarcoma should be suspected in multiple leiomyomas and in cases of a rapidly growing pelvic or fibroid mass [2–5, 7]. The tumour may be associated with abdominal pain, but patients are mainly asymptomatic, particularly if the lesion originates in the retroperitoneal space, in which case diagnosis is delayed and the prognosis is worse [1, 2]. Diagnosis is incidental in almost one-third of cases.…”

“…CT reveals large masses with heterogeneous contrast, cystic and necrotic components, and vascular hypertrophy [3, 5]. An MRI may also be useful for the diagnosis if a venous leiomyosarcoma is suspected [2].…”

“…Radical surgical criteria should be considered. En bloc resection with negative margins has been reported to achieve the best prognosis, with a 5-year survival rate in 33-68% of the cases [1, 2, 8].…”

“…Arising from smooth muscle cells of the vessel wall, it is most commonly located in the inferior cava (50% of cases), but it may also occur in renal, mesenteric, hepatic, saphenous, or gonadal veins. These leiomyosarcomas are more common in women than in men, and they are generally found in the older population (mainly postmenopausal women) [1, 2]. Approximately 200 cases of leiomyosarcoma in the inferior cava vein have been reported to date [1–6].…”

“…Areas of necrosis and mononuclear giant cells are observed. Immunohistochemistry is positive for desmin, vimentin, and smooth cell actin, but not for S-100 protein or neuron-specific enolase [1, 2, 4, 7].…”