title: Pararenal vena cava leiomyosarcoma versus leiomyomatosis: difficult diagnosis.
abstract: Inferior vena cava (IVC) leiomyosarcoma is a rare cancer treated with wide surgical resection. IVC leiomyomatosis is a benign tumor treated with open caval excision. A patient with an IVC tumor with iliocaval thrombosis was treated with thrombolysis and iliac stents. The patient was sent 1 year later to our institution with an IVC mass. Transvenous biopsy was consistent with leiomyomatosis. At surgery, the lesion was adherent, resected and the IVC reconstructed. Pathologic evaluation documented well-differentiated leiomyosarcoma not leiomyomatosis. Thorough evaluation of iliocaval thrombosis is recommended before endovascular management. Diagnostic modalities may be inadequate to differentiate leiomyosarcoma from leiomyomatosis.
authors.affiliation: Section of Vascular Surgery, Geisinger Medical Center, 100 N Academy Avenue, Danville, PA 17822-2150, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Armstrong
authors.forename: David P
authors.initials: DP
authors.lastname: Franklin
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018231:Leiomyomatosis / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D007890:Leiomyosarcoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D011859:Radiography; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D019043:Vascular Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery