Abstract
A leiomyosarcoma was detected in the region of the left iliac vein in a 37-year-old
male patient who had experienced intermittent swelling of the left leg for a period
of 3 months prior to admission. The results of the diagnostic imaging procedures carried
out (ultrasonography, CT scan, phlebography) all pointed to a thrombus affecting the
iliac vein. None of the other diagnostic procedures employed provided any evidence
of a malignant disease. The definitive diagnosis was made only on the basis of the
histological workup of the material obtained during surgery. The patient died 22 months
after establishment of the initial diagnosis with hepatic, pulmonary, renal, and splenic
metastatic disease having developed in the meantime. Treatment with chemotherapy and
hyperthermia failed to prevent this fatal outcome. This case shows that, in the presence
of atypically located “thrombi,” differential diagnostic considerations prior to thrombolytic
treatment and surgery should include a tumor, particularly when previous thrombolytic
treatment has proved ineffective.
