[Leiomyosarcoma of the inferior vena cava].
METHODS
In a 34-year-old woman who underwent ultrasound investigation because of recurrent pyelonephritis a space-occupying lesion in the liver was an incidental finding. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed a tumour in segment I of the liver. The patient had been on contraceptives for 12 years. She had no symptoms.


METHODS
Laboratory tests, including tumour markers, were unremarkable. Diagnostic tests to exclude malignant tumour with metastases were negative (thyroid scintigraphy, mammography, coloscopy and gastroscopy). Further tests (ultrasound, coeliaco-mesentericography, hydro-CT and spiral CT, MRI) revealed a tumour, 5 x 4 x 4 cm, in segment I of the liver, most likely an adenoma. Surgical intervention was indicated by the size and questionable malignancy of the tumor.


METHODS
At operation a tumour was found which originated from the inferior vena cava (IVC) and displaced segment I of the liver. The tumour was resected and the venous wall reconstructed with a Goretex patch. Histological examination indicated a poorly differentiated leiomyosarcoma of the IVC. Adjuvant radiotherapy was undertaken postoperatively. There has been no evidence of recurrence after 10 months.


CONCLUSIONS
Leiomyosarcoma of the IVC can be mistaken, both by ultrasound and tomographic diagnostic procedures, for a tumour in segment I of the liver, especially an adenoma. A leiomyosarcoma of the IVC should be included in the differential diagnosis of an hepatic tumour that lies close to segment I of the liver.
Schwarzbach
M
M
Chirurgische Klinik, Ruprecht-Karls-Universität Heidelberg. Matthias_Schwarzbach@krzmail.krz.uni-Heidelberg.de
Willeke
F
F
Hoffmann
V
V
Mechtersheimer
G
G
Otto
G
G
D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D001807:Blood Vessel Prosthesis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D014682:Vena Cava, Inferior / Q000601:surgery
Leiomyosarkom der Vena cava inferior.