Leiomyosarcoma: a rare but fatal tumour of the inferior vena cava

Description

Leiomyosarcomas (LMS) of the inferior vena cava (IVC) are a rare entity. Signs and symptoms vary greatly, such as abdominal pain, weight loss/gain, fever, weakness, anorexia or vomiting. CT scan is the imaging modality of choice for evaluation of retroperitoneal LMS, but biopsy is necessary to establish the diagnosis.

A 62-year-old woman presented with intermittent, diffuse, dull and sharp abdominal pain radiating to the lower back, associated with nausea, bloating and constipation. She also had a 15-pound weight gain in 6 months. Prior work-up did not reveal any acute abnormalities and she received treatment for constipation.

Due to persistent symptoms, CT of the abdomen and pelvis was ordered and demonstrated heterogeneously enhancing mass of the IVC extending into the right atrium (figure 1A,B). CT of the chest was done and confirmed the extension of the tumour to the right atrium (figure 1C,D). Figure...

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