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. 2021 Nov:88:106565.
doi: 10.1016/j.ijscr.2021.106565. Epub 2021 Nov 3.

Primary leiomyosarcoma of the great saphenous vein: A case report

Ruben Tresgallo-Parés  1 , Lucas De Virgilio-Salgado  2 , Norberto J Torres-Lugo  3 , Natalia A Asenjo-Molina  4 , Norman Ramirez  5 , Juan Bibiloni-Rodríguez  1
Affiliations

Primary leiomyosarcoma of the great saphenous vein: A case report

Ruben Tresgallo-Parés et al. Int J Surg Case Rep. 2021 Nov.

Abstract

Introduction and importance: Vascular smooth muscle sarcomas are rare neoplasms that comprise less than 2% of all leiomyosarcomas. These malignancies usually originate in the inferior vena cava, with a limited number of cases affecting the great saphenous vein. Due to the limited reports on these sarcomas, epidemiologic data remains insufficient.

Case presentation: We report the case of a 67-year-old Hispanic female that presented with an asymptomatic growing mass in her right thigh. She was managed with an En bloc resection under the impression of a smooth muscle vascular sarcoma. The diagnosis was confirmed after histopathologic evaluation.

Clinical discussion: Vascular leiomyosarcomas remain a rare and challenging diagnosis. They usually present as a slowly growing mass that is initially asymptomatic. High clinical suspicion and a comprehensive radiologic evaluation, including magnetic resonance imaging, are crucial. Histopathological evaluation is essential for diagnostic confirmation. Surgical excision remains the treatment of choice, with radiation therapy mostly considered for local disease control. Postsurgical surveillance is necessary every three months to monitor for signs of recurrence.

Conclusion: Physicians should remain aware of the nonspecific presentation of leiomyosarcomas and the importance of a comprehensive diagnostic approach. Early diagnosis and adequate management are fundamental elements in the treatment of these aggressive tumors.

Keywords: Case report; Excision; Great saphenous vein; Leiomyosarcoma; Metastasis; Recurrence.

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Conflict of interest statement

The authors have no conflict to disclose.

Figures

Fig. 1
Fig. 1
Color Doppler ultrasound - showing an endoluminal vascular mass within the greater saphenous vein (GSV).
Fig. 2
Fig. 2
Contrast enhanced magnetic resonance images – showing a soft tissue mass that arises from the greater saphenous vein along the distal medial aspect of the right thigh. Sagittal T1 fat sat with contrast (A), Axial T1 fat sat with contrast (B), Axial T2 (C), and Axial T2 fat sat (D).
Fig. 3
Fig. 3
Microscopic evaluation - hematoxylin and eosin stain of surgical specimen in low power (10×) magnification (A), and high power (40×) magnification (B).
See this image and copyright information in PMC

References

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