Aleena Elizabeth Andrews1, Juvaina Puthiyakam2, Naufal Perumpalath3, Devarajan Ellezhuthil4
BACKGROUND
Leiomyosarcomas (LMS) of inferior vena cava (IVC) are rare smooth muscle
sarcomas with less than 300 cases described in the literature. Leiomyosarcoma of
IVC is, often detected late in the course due to its indolent manifestation. This
study intends to discuss the experiences and challenges in diagnosing this rare
entity primarily by radiological imaging in a tertiary centre in India.
METHODS
This is a retrospective analysis of computed tomography (CT) and ultrasound
findings in 6 cases of leiomyosarcoma of inferior vena cava who were referred for
multidetector computer tomography (MDCT) scan in the Department of
Radiodiagnosis of Government Medical College Calicut over the past 7 years by
the treating physician. The patients were identified using a prospectively
maintained database.
RESULTS
In this study, there were six patients diagnosed as leiomyosarcoma of IVC, age
ranging from 35 and 64 years (mean 47.8 years, SD 10.7) with 4 (66.6 %) females
and 2 (33.33 %) males. The mean size of the tumour at the time of diagnosis was
8.4 cm. The segment of IVC most commonly involved was middle segment in 5
patients (83.3 %). In this series, only a single case had tumour entirely confined
within the lumen of inferior vena cava without extraluminal extension. Two out of
six cases (16.66 %) had lung metastasis at the time of diagnosis. Two cases
without metastasis or significant infiltration to adjacent organs were amenable to
resection.
CONCLUSIONS
Leiomyosarcoma of IVC is a rare tumour, often detected late in the course due to
its indolent manifestation. High index of suspicion may help in the early diagnosis
of so that early treatment can begin and improve the clinical outcome.
