title: Radiation-induced leiomyosarcoma of the great vessels presenting as superior vena cava syndrome.
abstract: A patient with a pleomorphic intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presented clinically with a superior vena cava syndrome. A latent period of 29 years elapsed between receiving orthovoltage radiation to the neck and right side of chest to treat recurrent ganglioneuroblastoma, and the appearance of a leiomyosarcoma and subsequent recurrences. The patient underwent partial resection of the tumor, received adjunct chemotherapy, and was shown to be free of disease by clinical tests and by magnetic resonance imaging (MRI) 17 months after completion of chemotherapy. The criteria for the diagnosis of radiation-induced sarcomas are reviewed in relation to the present case. The critical role of magnetic resonance imaging in both the diagnosis and continued follow-up of the patient is described. This would appear to be the first reported case of radiation-induced intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presenting as a superior vena cava syndrome.
authors.forename: K S
authors.initials: KS
authors.lastname: Weiss
authors.forename: B L
authors.initials: BL
authors.lastname: Zidar
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.forename: G J
authors.initials: GJ
authors.lastname: Magovern
authors.forename: R N
authors.initials: RN
authors.lastname: Raju
authors.forename: A R
authors.initials: AR
authors.lastname: Lupetin
authors.forename: S E
authors.initials: SE
authors.lastname: Shackney
authors.forename: S R
authors.initials: SR
authors.lastname: Simon
authors.forename: M
authors.initials: M
authors.lastname: Singh
authors.forename: R P
authors.initials: RP
authors.lastname: Pugh
mesh_terms: D000328:Adult; D016122:Brachiocephalic Trunk; D003937:Diagnosis, Differential; D005260:Female; D005729:Ganglioneuroma / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D009682:Magnetic Resonance Spectroscopy; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis* / Q000473:pathology; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis*