Primary venous leiomyosarcoma: A rare but lethal disease

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Presentation transcript:

Primary venous leiomyosarcoma: A rare but lethal disease Csaba Dzsinich, MD, PhD, Peter Gloviczki, MD, Jon A. van Heerden, MD, ChB, David M. Nagorney, MD, Peter C. Pairolero, MD, C.Michael Johnson, MD, John W. Hallett, MD, Thomas C. Bower, MD, Kenneth J. Cherry, MD Journal of Vascular Surgery Volume 15, Issue 4, Pages 595-603 (April 1992) DOI: 10.1016/0741-5214(92)90003-Q Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 A, Sagittal section of a magnetic resonance image shows a huge infrahepatic solid tumor (outlined by arrows) displacing the right kidney and the bowels. B, Axial section of the same magnetic resonance image demonstrates the inhomogeneous tumor mass with an indistinct margin and no cleavage plane between the tumor and the IVC. The tumor occupies half of the caval lumen (arrow). C, Postoperative magnetic resonance angiogram of the same patient confirms patency of the IVC (arrow), which was reconstructed with a Dacron patch after resection of the tumor of the lower segment. Journal of Vascular Surgery 1992 15, 595-603DOI: (10.1016/0741-5214(92)90003-Q) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Ascending phlebography of the IVC. The large curvilinear filling defect (arrow) in the infrarenal segment of the cava was caused by a recurrent primary caval leiomyosarcoma. Journal of Vascular Surgery 1992 15, 595-603DOI: (10.1016/0741-5214(92)90003-Q) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Ascending phlebography of a 19-year-old patient with primary leiomyosarcoma of the left external iliac vein. Arrow indicates high-grades narrowing, caused by the tumor. B, Arteriography of the same patient shows a moderate stenosis of the external iliac artery (arrow) caused by invasion of the adventitia by the tumor. Journal of Vascular Surgery 1992 15, 595-603DOI: (10.1016/0741-5214(92)90003-Q) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Localization of primary venous leiomyosarcoma in 13 patients. The lower (I) segment of the IVC is the infrarenal part, the middle (II) segment involves the entry of renal veins and the cava up to the hepatic veins. The upper (III) segment extends from the hepatic veins to the right atrium. Journal of Vascular Surgery 1992 15, 595-603DOI: (10.1016/0741-5214(92)90003-Q) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions