Document Detail


An extraluminal leiomyosarcoma of the iliac vein without thrombosis--a case report.
MedLine Citation:
PMID:  11586457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vascular leiomyosarcoma (LMS)is a rare malignant tumor arising from the muscle cells of the media of the vessels. Vascular LMS is often diagnosed as a result of the clinical manifestations of impaired venous flow such as edema and phlebothrombosis. The authors present a case of an LMS in a 72-year-old woman. Physical examination revealed a round mass deep in the left inguinal region close to the inguinal vessels, fixed and not pulsating. There was no sign of left lower-limb edema nor of articular impairment of the hip. Inguinal and distal pulses were normal. Results of laboratory analysis, including values for the oncologic markers, were normal. An ultrasound scan of the left inguinal fossa showed a 50-by-30 mm mass of mixed aspect that adhered to the left common iliac artery. An echo color Doppler showed conservative arterial flow. Thus, a thrombotic aneurysm of the left iliac artery was diagnosed. Chest x-ray showed no pathological findings. An abdominal computerized tomograph (CT) scan confirmed the location of the neoplasm and revealed a narrowing of the left iliac vein compressed behind the mass. The finding was interpreted as a colliquative lymph node. The patient underwent explorative laparotomy with midline incision. The finding was a neoplastic bilobed mass compressing and infiltrating the left iliac vein with no cleavage surface between the mass itself and the venous wall. An intraoperative frozen section revealed a necrotic mass with a cortex of ambiguous interpretation. Surgical procedure was then finished with no further venous resection. Histologic examination revealed the presence of leiomyosarcomatous tissue with nuclear pleomorphisms inside necrotic material limited by a thin fibrotic capsule. According to Coindre's classification the tumor was a G3. After six months the patient is fit and a CT scan showed no evidence of recurring disease.
Authors:
M Prandi; S Scabini; M P Taviani
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Vascular surgery     Volume:  35     ISSN:  0042-2835     ISO Abbreviation:  Vasc Surg     Publication Date:    2001 Jul-Aug
Date Detail:
Created Date:  2001-10-04     Completed Date:  2001-11-01     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0103277     Medline TA:  Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-4     Citation Subset:  IM    
Affiliation:
I Scuola di Specializzazione in Chirurgia Generale, University of Genoa, Corso Europa 506-11, 16132 Genoa, Italy. prandi@libero.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Diagnosis, Differential
Female
Humans
Iliac Vein* / pathology
Leiomyosarcoma / diagnosis*
Neoplasms, Muscle Tissue / complications,  diagnosis
Vascular Neoplasms / diagnosis*
Venous Thrombosis / diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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