Background: Leiomyosarcoma of the iliac vein is a very uncommon tumour. Prognosis is usually poor and the best treatment is unknown. Case report: We report the case of a 74-year-old woman presenting a right leg oedema. Venous colour doppler was normal. Abdominal ultrasound and magnetic resonance scanning demonstrated a 70 mm mass in the right pelvis with a well-defined profile, which was not homogeneous after contrast enhancement. The lesion was in close contact with the iliac vessels and the right iliac vein profile was inside the mass. Serum markers were in the normal range. The patient underwent an exploratory laparotomy by a team of Gynecologic Oncologists for the suspicion of ovarian cancer, but a retroperitoneal tumour on the wall of the right common iliac and external iliac veins was found. With the help of a vascular surgeon the tumour was resected en bloc and polytetrafluoroethylene grafts were used to reconstruct the vessels. The postoperative course was uneventful. On histological examination a leiomyosarcoma of the iliac vein was found. The patient received adjuvant chemotherapy. Three years after surgical resection no signs of recurrence or postoperative complications were detected. Conclusions: Leiomyosarcoma of the iliac vein is a rare option to consider in the management of a pelvic mass. Radical surgical excision with polytetrafluoroethylene grafts reconstruction followed by adjuvant chemotherapy was feasible and effective.
Leiomyosarcoma of the Right Iliac Vein Presenting as a Pelvic Mass: A Case Report
Ferrero A
2015-01-01
Abstract
Background: Leiomyosarcoma of the iliac vein is a very uncommon tumour. Prognosis is usually poor and the best treatment is unknown. Case report: We report the case of a 74-year-old woman presenting a right leg oedema. Venous colour doppler was normal. Abdominal ultrasound and magnetic resonance scanning demonstrated a 70 mm mass in the right pelvis with a well-defined profile, which was not homogeneous after contrast enhancement. The lesion was in close contact with the iliac vessels and the right iliac vein profile was inside the mass. Serum markers were in the normal range. The patient underwent an exploratory laparotomy by a team of Gynecologic Oncologists for the suspicion of ovarian cancer, but a retroperitoneal tumour on the wall of the right common iliac and external iliac veins was found. With the help of a vascular surgeon the tumour was resected en bloc and polytetrafluoroethylene grafts were used to reconstruct the vessels. The postoperative course was uneventful. On histological examination a leiomyosarcoma of the iliac vein was found. The patient received adjuvant chemotherapy. Three years after surgical resection no signs of recurrence or postoperative complications were detected. Conclusions: Leiomyosarcoma of the iliac vein is a rare option to consider in the management of a pelvic mass. Radical surgical excision with polytetrafluoroethylene grafts reconstruction followed by adjuvant chemotherapy was feasible and effective.
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