Radiographic features of intraluminal leiomyosarcoma of the inferior vena cava: An atypical case report

ArticleinAbdominal Imaging 36(5):586-9 · October 2011with22 Reads
DOI: 10.1007/s00261-010-9673-x · Source: PubMed
We encountered a 74-year-old woman with a chief complaint of progressive right-sided back pain for more than 1 month. Physical examination and laboratory tests revealed no abnormalities. Multislice computed tomography (MSCT) showed dilatation of the inferior vena cava (IVC). An intraluminal mass of about 8.1 × 5.5 × 3.6 cm in size was found in the IVC, with big central necrosis and irregular peripheral enhancement. The tumor arose from the IVC just beneath the renal vein and reached the iliac bifurcation. Cavography demonstrated a filling defect with complete occlusion of the IVC and extensive collateral circulation. The patient underwent complete resection of tumor and vascular prosthetic graft. Pathological diagnosis was leiomyosarcoma. Because of its low incidences and atypical appearance, we highlight the significance of the imaging feature in its diagnosis in this article.
    • "This rarity of IVC occlusion as an etiology for radiculopathic pain is demonstrated by Paksoy et al., who found in a cohort of 9,640 patients with lumbar back pain or radiculopathic symptoms that only 10 patients had an underlying IVC thrombosis [19]. Engorgement of Batson's plexus culminating in radiculopathic pain has been reported for a few rare disease processes: IVC obstruction secondary to Budd- Chiari syndrome, arteriovenous malformation, thrombosis, or a compressing abdominal mass202122. Although diagnostically challenging because it closely mimics much more common pathologies such as disc herniation or spinal stenosis, cord compression secondary to engorgement of the epidural venous plexus must be considered on the differential for all patients with an IVC filter who present with lower extremity pain or weakness1920. "
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