title: Superior vena cava syndrome due to a leiomyosarcoma of the anterior mediastinum: A case report and literature overview.
abstract: BACKGROUND
  Leiomyosarcomas are an infrequent cause of malignant superior vena cava syndrome (VCS).
  
  
  METHODS
  A 51-year old male patient was admitted for a three-day history of dyspnoea, dysphagia and erythema of the head and neck. Computed tomography and magnetic resonance imaging showed a lesion arising on the anterior mediastinum, which was in close proximity with a thrombus in the superior vena cava. Surgical excision was performed, including open resection of the primary tumour and an atrio-innominate vein bypass with 8-mm polytetrafluoroethylene (PTFE). Histology confirmed a leiomyosarcoma and postoperative radiotherapy sessions were performed. Due to evidence of enlargement of the thrombus, a second intervention was undertaken. In this procedure, a remainder of the primary tumour was resected and the superior vena cava reconstructed with an autologous pericardium patch. The patient recovered satisfactorily and was discharged on the seventh postoperative day, with no evidence for relapse after 10 months of follow-up.
  
  
  CONCLUSIONS
  Leiomyosarcomas comprise less than 2% of the tumours of the mediastinum and are a rare cause of paraneoplastic VCS. Male patients in their sixties are most commonly affected. Relapses seem to be common, and thus a careful follow-up is often recommended.
  
  
  CONCLUSIONS
  In spite of the limited data on the management of thoracic leiomyosarcomas, surgery is currently considered the mainstay of treatment.
authors.affiliation: Departamento de Cirugía Vascular, Hospital Naval Almirante Nef, Viña del Mar, Chile. Electronic address: dr.eduardo.labarca@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Labarca
authors.affiliation: Departamento de Cirugía Cardiaca, Hospital Naval Almirante Nef, Viña del Mar, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Zapico
authors.affiliation: cultad de Medicina, Universidad Andrés Bello, Viña del mar, Chile.
authors.forename: B
authors.initials: B
authors.lastname: Ríos
authors.affiliation: entro de Investigaciones Biomédicas, Escuela de Medicina, Universidad de Valparaíso, Chile.
authors.forename: F
authors.initials: F
authors.lastname: Martinez
authors.affiliation: Departamento de Imagenología, Hospital Naval Almirante Nef, Viña del Mar, Chile.
authors.forename: M
authors.initials: M
authors.lastname: Santamarina
keywords: Leiomyosarcoma; Superior vena cava syndrome; Vascular neoplasms