Leiomyosarcoma of the inferior cava vein: case report

Leiomyosarcoma of the inferior cava vein is a rare clinical entity and according to the literature has been described in less than 300 patients. C.S., 54 yrs old, male, artisan, came to our observation in March 2005 for abdominal pain (upper right quadrant) and asthenia. Ultrasound demonstrated the presence of a gallbladder lithiasis and an echogenic mass, 7 × 8 cm, in retroperitoneal space, behind the liver. Computed tomography confirmed the presence of the mass apparently originating from middle cava vein. This mass displaced duodenum, common bile duct and pancreatic head. Doppler examination demonstrated the permeability of cava vein. Mass was resected together with anterior wall of the cava vein. Histological finding demonstrated an encapsulated high-grade leiomyosarcoma (Ki67/Mib1 index: 20%, alfa-actin positive, desmin positive, h-caldesmon positive). Leiomyosarcoma of the inferior cava vein is a rare, potentially aggressive neoplasma. Nowadays, surgery performed by an interdisciplinary team represents gold standard treatment, even if adjuvant therapy role should be demonstrated.