Great saphenous vein leiomyosarcoma mimicking thrombosed aneurysm: A case report and review of the literature

Abstract

Vascular leiomyosarcoma LMS. is an extremely rare subgroup of LMSs. Fewer than 50 cases of LMS originating from the great saphenous vein have been reported. In 43% of reported cases, LMS was misdiagnosed clinically. In our case, the patient was initially misdiagnosed as having a thrombosed aneurysm. This misdiagnosis could be due to the rarity of great saphenous vein LMS cases, for which a high index of suspicion is needed, and because no specific radiologic findings have been established for diagnosing LMSs. Masses presenting along the course of vessels should be suspected for malignancy, which can be helpful in performing definitive surgery and avoiding multiple surgeries.

Keywords: Great saphenous vein; Leiomyosarcoma; Venous aneurysm.

Fig 1

Axial view showing enhancing mass within great saphenous vein (GSV) with cystic spaces.

Fig 2

Coronal view showing extension of mass along course of great saphenous vein (GSV) into common femoral vein. Note mild enhancement of some portions of the mass, which led to the misdiagnosis. This was falsely reported as an aneurysmal dilation with internal thrombosis.

Fig 3

Coronal view of contrast-enhanced magnetic resonance imaging (MRI) showing an inhomogeneously enhancing mass within the proximal great saphenous vein (GSV) expanding the lumen. Less prominent enhancement is present in its superior portion, mimicking a filling defect and thrombosis.