Primary External Iliac Vein Leiomyosarcoma

Sahu, Rajan; Aggarwal, Rajeev; Kumar, Pankaj; Mittal, Sakshi; Sood, Vineeta; Sarin, Jatin

doi:10.1016/j.avsg.2018.09.030

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…LMS can present as an intravenous tumor of the deep veins. Although vascular LMS is rare, accounting for less than 2% of all LMSs, limited case reports do exist [ 13 – 16 ]. Most vascular LMS cases are located in the iliac vein, as was observed in our patient [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Venous Thromboembolism in Metastatic Uterine Leiomyosarcoma: A Case Report and Review of the Literature

Swisher,

Ornelas,

Ornelas

et al. 2023

Case Rep Oncol

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We report an unusual case of extensive deep vein thrombosis (DVT) and pulmonary embolism (PE) in the setting of metastatic uterine leiomyosarcoma. Recognition of the associated sequelae of this condition may improve short- and long-term outcomes. A 56-year-old black female with a history of uterine leiomyosarcoma diagnosed incidentally after total abdominal hysterectomy for fibroid uterus without initiation of chemoradiation treatment presented to the emergency department complaining of generalized weakness and progressively worsening stridor for 2 weeks. The patient was experiencing shortness of breath, dysphagia, and hoarseness. Physical exam was remarkable for rhonchi but was otherwise normal. Diagnostic imaging via CT of the abdomen, pelvis, and chest revealed DVTs of the left common and external iliac veins, the superior mesenteric artery, multiple pulmonary emboli of the right pulmonary artery, several nodular lesions within the lungs, and scattered peritoneal necrotic lesions, which were suspicious for metastatic disease. Additionally, CT of the neck showed an exophytic mass protruding into the airway from the subglottic region and thyromegaly with bilateral thyroid lobe nodules. The patient was subsequently started on Eliquis and chemotherapy. The rarity of this case is rooted in the extent of the patient’s DVTs and PEs secondary to hypercoagulability in metastatic cancer. This presentation should be further evaluated to exclude thrombophilias or underlying malignancies. Drawing from the lessons of this case will help guide future clinical management regarding the care of metastatic uterine leiomyosarcoma.

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Section: Discussionmentioning

confidence: 99%

Venous Thromboembolism in Metastatic Uterine Leiomyosarcoma: A Case Report and Review of the Literature

Swisher,

Ornelas,

Ornelas

et al. 2023

Case Rep Oncol

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“…Leiomyosarcoma of the major veins is a rare extraperitoneal tumor that originates from vascular smooth muscle cells 2 , 3 . In the world literature, about 400 observations of patients with leiomyosarcoma of the inferior vena cava have been published 2 .…”

Section: Discussionmentioning

confidence: 99%

“…The tumor most frequently arises from the inferior vena cava; rarely, it develops from the great saphenous, femoral, or internal jugular vein. Leiomyosarcoma of the iliac vein is rare 3 . There are single observations of such patients described.…”

Section: Discussionmentioning

confidence: 99%

Two-stage combined treatment of leiomyosarcoma of iliac vein using robotic surgery

Берелавичус¹,

Зотиков²,

Кригер³

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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Vascular leiomyosarcoma is a rare tumor originating from the vascular smooth muscle cells. Leiomyosarcomas of the external iliac vein are extremely rare. Only single observations of this tumor are reported. We describe a 48-year-old woman who underwent a two-step combined treatment: robot-assisted removal of the extraperitoneal tumor and removal of the lower part of the tumor from the open femoral approach. There have been no signs of tumor recurrence during the 34-month follow-up period.

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“…Reports of LMS originating from the external iliac vein are especially rare, and to our knowledge only 3 cases have been reported. [ 3 , 4 , 5 ] Venous LMS has clinical signs that may be confused with those of DVT, thus causing delay in the correct diagnosis and timely intervention. However, an unsuccessful clinical course of a presumed DVT should raise suspicion for an alternative diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Primary external iliac vein leiomyosarcoma in a young female diagnosed by contrast-enhanced ultrasound

Xiao-chen

Gao²,

Zhang³

2020

Medicine

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Rationale: Venous leiomyosarcoma (LMS) is a malignant tumor arising from the smooth muscle cell of the vein wall. The diagnosis of venous LMS is usually delayed owing to its rarity, absence of serological markers, and mimicry with deep vein thrombosis (DVT). Herein, we report a case of a primary external ilian vein LMS characterized by long-term, unexplained DVT in the left lower limb. Contrast-enhanced ultrasound (CEUS) played a crucial role in the preoperative diagnosis. No improvement was observed in the lower limb status; a rapid, high-level, heterogeneous wash-in and wash-out mass of the vein, as seen with CEUS, could indicate angiogenic malignancy. CEUS also helped evaluate the percent of intratumoral necrosis, which is an important parameter for predicting the prognosis. Patient Concerns: A 37-year-old Chinese women presented to the Vascular Surgery Department of our hospital for accurate diagnosis of her condition. She began experiencing edema and pain in her left leg 2 years ago. She was diagnosed with DVT in the left lower extremity and was administered anticoagulant therapy since then. However, her symptoms started to aggravate 8 months ago. Diagnoses: The laboratory results including D-dimer, prothrombin time (PT), activated partial thrombin time (APTT), and prothrombotic conditions screening were within normal ranges. A pelvic ultrasound detected a heterogeneous, hypoechoic mass compressing the external iliac vein and obstructing the venous drain of the lower extremity. The mass showed a rapid, high-level, heterogeneous wash-in and wash-out on CEUS, which suggested angiogenic malignancy. Contrast-enhanced CT (CECT) confirmed the result of CEUS but revealed no metastasis. Interventions: She underwent complete surgical removal of the tumor, which was resected successfully. There was no infiltration in the inguinal nodes sent for the study. Outcomes: Pathological examination and immunohistochemistry confirmed that the mass was a well-differentiated LMS originating from the external iliac vein. There was no sign of local recurrence or distant metastasis during a 12–month follow-up. Lessons: Effective imaging techniques and differential diagnosis of venous LMS is vital and should be considered for patients with chronic thrombosis presenting with normal laboratory results.

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Primary External Iliac Vein Leiomyosarcoma

Cited by 4 publications

References 15 publications

Venous Thromboembolism in Metastatic Uterine Leiomyosarcoma: A Case Report and Review of the Literature

Venous Thromboembolism in Metastatic Uterine Leiomyosarcoma: A Case Report and Review of the Literature

Two-stage combined treatment of leiomyosarcoma of iliac vein using robotic surgery

Primary external iliac vein leiomyosarcoma in a young female diagnosed by contrast-enhanced ultrasound

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