Vascular leiomyosarcoma arising from the inferior vena cava diagnosed by intraluminal biopsy

Abstract

A 61-year-old woman developed pain in the right thigh, paraplagia of the lower extremities and lumbago in November 1996. A lumbar spine roentgenogram showed lytic change in L2, and magnetic resonance imaging showed a patchy destructive lesion and compression of the dural sac from the right by a tumour. Computed tomography (CT) myelography showed a motheaten destructive lesion in L2 and projection of the tumour into the spinal canal. Abdominal ultrasound, CT and cavography showed dilatation of the inferior vena cava (IVC) and an intraluminal tumour about 2x2.8x4 cm in size in the IVC. The tumour arose from the IVC just beneath the renal vein and extended to just short of the right atrium. Both vertebral and intraluminal biopsy materials showed the same morphology, in which atypical spindle cells admixed with multinucleated giant cells proliferated in a fascicular growth pattern. Neoplastic cells were strongly positive for alpha-smooth muscle actin. We diagnosed vascular leiomyosarcoma arising from the IVC with metastasis to the lumbar vertebrae. Cases of vascular leiomyosarcoma diagnosed by intraluminal biopsy are rare.

Directing phenotype of vascular smooth muscle cells using electrically stimulated conducting polymer

“…Moreover, during development, rapid proliferation of SMCs occurs simultaneously with differentiation [51]. Interestingly, malignant tumours of vascular smooth muscle origin, such as leiomyosarcomas, although very rare, also demonstrate increased proliferation with strong simultaneous expression of contractile proteins such as SMA [52][53][54][55][56], SMMHC [55,56], desmin [52,55,56], h-caldesmon [55] and calponin [54].…”

Primary intravascular myxoid leiomyosarcoma of the femoral vein presenting clinically as deep vein thrombosis: a case report

“…Vascular leiomyosarcomas usually occur in the inferior vena cava [6], whereas leiomyosarcomas of femoral vein are a rare entity. To date, fewer than approximately 40 cases have been reported [1].…”

Leiomyosarcoma of inferior vena cava presenting as budd-chiari syndrome

“…Our patient had most of the poor prognostic factors and finally a fatal outcome. Specific diagnosis can be established by ultrasonography or CT guided needle biopsy or intraluminal biopsy [6]. Aggressive surgical treatment combined with radiation and chemotherapy offer the best chances of survival [3].…”