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Vol. 66. Núm. 3.
Páginas 153-154 (Mayo - Junio 2014)
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Vol. 66. Núm. 3.
Páginas 153-154 (Mayo - Junio 2014)
Clinical Image of the Month. Solution
DOI: 10.1016/j.angio.2014.03.006
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Solution to Case 2. Leiomyosarcoma of the inferior vena cava revealed by lower extremities edema
Solución del caso 2. Leiomiosarcoma de vena cava inferior y edema de extremidades inferiores
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M. Mahmoud
Autor para correspondencia
Mahmoud.maha@gmail.com

Corresponding author.
, M.B. Messaoud, H. Riahi, O. Azaiz
Medical Imaging Department La Rabta, Tunis El Manar University, Tunis, Tunisia
Contenido relaccionado
Angiologia. 2014;66:151-210.1016/j.angio.2014.02.013
M. Mahmoud, M.B. Messaoud, H. Riahi, O. Azaiz
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Commentation

In this patient, abdominal CT scan revealed a large retroperitoneal solid mass heterogeneously enhanced after contrast injection (Fig. 1). This mass was centered on the inferior under renal vena cava which was no more individualized. It had irregular borders and was associated with iliac veins thrombosis. It invaded the lumbar segment of right ureter. It invaded the right psoas muscle and was in contact with the spine. Onward, it came in contact with the third duodenum. The inferior vena cava above renal was permeable (Fig. 2).

Figure 1.

Abdominal CT scan, axial view: large retroperitoneal solid mass (white arrowheads), heterogeneously enhanced after contrast injection, with large contact with aorta and no visualization of the inferior vena cava.

(0,09MB).
Figure 2.

Abdominal CT scan, frontal view: heterogeneous mass (white star) centered on the inferior under renal vena cava causing iliac veins thrombosis (white arrows) which are no more filled with contrast. Above renal inferior vena cava (black arrows).

(0,23MB).

The patient underwent CT-guided needle core biopsy. Histological examination showed a malignant mesenchymal proliferation. An immunohistochemical study was performed. Morphological and immunohistochemical features were consistent with leiomyosarcoma1,2.

Answer to question: b.

Diagnosis: Histológico (biopsia guiada por TC): Leiomiosarcoma.

References
[1]
M.N. Kulaylat, C.P. Karakousis, R.J. Doerr, H.L. Karamanoukian, J. O’Brien, R. Peer.
Leiomyosarcoma of the inferior vena cava: a clinicopathologic review and report of three cases.
J Surg Oncol, 65 (1997), pp. 205-217
[2]
A. Mingoli, R.J. Feldhaus, A. Cavallaro, S. Stipa.
Leiomyosarcoma of the inferior vena cava: analysis and search of world literature on 141 patients and report of three new cases.
J Vasc Surg, 14 (1991), pp. 688-699
Copyright © 2014. SEACV
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