Leiomyosarcoma of Superior Vena Cava and Inferior Vena Cava - Two Rare Case Reports

Abstract

Objective: This article attempts to describe two cases of vascular leiomyosarcoma, one arising from the superior vena cava in a 22 year old male patient, and the other arising from the inferior vena cava in a 53 year old female. The objective was to investigate and diagnose the two cases. Material and Methods:Imaging studies (CT scan) were done in both the cases subsequent to initial clinical examination. After surgical resection, the specimens of the tumors were sent to the Pathology Department for histopathological examination. The sections were stained using Haematoxylin and Eosin (H & E). Immunohistochemistry (IHC) was also done.Results: On gross examination, the first case showed a segment of a large vessel with a mass attached to the inner wall and protruding outside through the lumen. Tumor on cut section was solid, firm, homogenous grayish white with focal necrotic areas.In the second case, the vessel wall with an attached firm to hard lesion was received. On histological examination, both the cases were diagnosed to be malignant spindle cell tumor. Immunohistochemical staining revealed that the tumor cells were diffusely positive for SMA and Desmin and negative for S100 and CK. The two cases were reported as vascular leiomyosarcoma, one of the Superior vena cava and the other case of Inferior vena cava. Conclusion:Vascular leiomyosarcoma is a very rare tumor and the Inferior vena cava is the most common site (50%). The Superior vena cava (SVC) is exceptionally involved and only a dozen cases have been previously reported. An accurate imaging and histopathological diagnosis is essential as they can affect the prognosis and treatment approach. So such cases should be thoroughly examined and followed.