Primary Leiomyosarcoma of the Inferior Vena Cava

Leiomyosarcoma of the inferior vena cava: A clinicopathologic review and report of three cases

“…Further extension into the pulmonary artery or its branches resulted in manifestations of pulmonary embolism in two cases (1.5%) [19,20]. Gastrointestinal hemorrhage occurred in three cases (2.3%) [21,49,52]. The source of bleeding in one case was not identified, was variceal in origin in the second, and the result of direct invasion of the duodenum by tumor in the third [21,49,52].…”

“…Gross pathology. LMS of the IVC originated from a localized area of the cava wall, thus forming the base of the tumor that measured 2 cm to 5.5 cm [10,[16][17][18][19][20][21][22]. It was sessile and in only two cases the tumor possessed a stalk (1.5%) [16,22].…”

“…Interference with the circulation on the right side of the heart by the tumor or tumor thrombus resulted in a host of manifestations. Patients presented with clinical picture of constrictive pericarditis, cardiac valvular, hepatic, renal, or pulmonary disease, idiopathic IVC thrombosis, deep vein thrombosis, or pulmonary embolism [2,3,9,12,13,[19][20][21]23,29,33,39,[49][50][51][52][53][54][55]. Budd-Chiari syndrome (BCS) (hepatomegaly, ascites, anasarca, hepatic failure and coma) developed in one-fourth of the cases.…”

“…Gastrointestinal hemorrhage occurred in three cases (2.3%) [21,49,52]. The source of bleeding in one case was not identified, was variceal in origin in the second, and the result of direct invasion of the duodenum by tumor in the third [21,49,52]. Compression of the renal artery by tumor resulted in renovascular hypertension in one case (0.75%) [56].…”

Leiomyosarcoma of inferior vena cava producing Budd‐Chiari syndrome

“…Growth within the lumen of the inferior vena cava is often extensive and in several instances has extended into the right atrium, so that cardiac catheterisation may exhibit a filling defect, as in the present case, and even suggest the diagnosis (Deutsch et al, 1968); in one instance (Hoffbrand and Lloyd- Thomas, 1964 filled the right atrium, obstructed the tricuspid valve, and extended into the right ventricle. Metastases are relatively uncommon; lymphatic spread to abdominal lymph-nodes has been observed in three cases (Kaliteevsky, 1961 ;Laufer and Plaschkas, 1961 ;Deutsch et al) and blood spread has been noted in two cases-to a rib (Hoffbrand and Lloyd- Thomas), and to the lung in the present case.…”