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Phlebologie 2014; 43(04): 190-193
DOI: 10.12687/phleb2205-4-2014
Case Report
Schattauer GmbH

Primary leiomyosarcoma of the venous vessel wall

A rare, fascinating case from routine vascular surgery and phlebology Article in several languages: English | deutsch
J. Bode
1   Artemed Fachklinik, Bad Oeynhausen, Germany
,
F. Wolter
1   Artemed Fachklinik, Bad Oeynhausen, Germany
› Author Affiliations
Further Information

Publication History

Received: 29 April 2014

Accepted: 04 May 2014

Publication Date:
04 January 2018 (online)

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Summary

Leiomyosarcomas account for only 6 % of soft tissue tumours. 20 % of them are associated with blood vessels, predominantly in the region of the inferior vena cava (1–4). It is an extremely aggressive tumour that causes un-specific symptoms especially in the lower extremities. In the absence of metastases, first-line treatment consists of complete resection of the tumour with a safety margin. This has a positive effect on the patient’s long-term survival (2, 5, 6). However, at the time of diagnosis more than 50 % of patients already have pulmonary or hepatic metastases (1–3). Generally, a multidisciplinary approach involving surgeons, pathologists, oncologists and radiologists is required.

This case report describes a 74-year-old male patient with a local swelling on the left proximal lower leg that had appeared about one year earlier. Histopathological examination of a frozen section revealed a leiomyosarcoma with moderate differentiation. Radical excision of the tumour with successful R0 resection was performed. No metastases could be demonstrated in further staging using computed tomography (CT). Almost three years after diagnosis, the patient is recurrence-free until now.

Keywords

Vascular leiomyosarcoma - inferior vena cava - frozen section technique - metastases - staging
 

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