Primary great saphenous vein leiomyosarcoma: Report of a case

Leiomyosarcomas rarely arise in primary veins, especially the great saphenous vein. We have found only 20 case reports of leiomyosarcoma arising in the great saphenous vein, most of which manifested as nonspecific symptoms of advanced disease, such as a palpable mass, swelling, and back or abdominal pain. We report the case of greater saphenous vein leiomyosarcoma diagnosed in a 48-year-old man with a 4-month history of an inguinal mass. Ultrasonography and computed tomography showed a 6-cm mass attached to the right superficial femoral vein. Fine-needle aspiration biopsy confirmed that it was a vascular sarcoma. At the time of surgery there was no evidence of distant metastasis; therefore, we removed the tumor en bloc along with the sartorius muscle, inguinal lymph nodes, and 10 cm of the common femoral vein, and replaced the femoral vein with a polytetrafluoroethylene graft. A pathological examination revealed poorly differentiated leiomyosarcoma of the great saphenous vein, involving the deep femoral vein, without lymph node involvement. During follow-up, a thrombosis of the prosthesis developed, followed by proximal stenosis, which was treated successfully with percutaneous transluminal angioplasty. The patient was found to have lung metastases 25 months after surgery and he died about 5 months later.     

Primary leiomyosarcoma of the jejunal mesentery: Report of a case

(Received for publication on May 29, 1996; accepted on Jan. 7, 1997)     

Primary leiomyosarcoma arising in the lesser sac: Report of a case

We describe herein a very rare case of leiomyosarcoma arising in the lesser sac. A 58-year-old man with a psychiatric disorder was admitted to our department for the investigation of epigastralgia and nausea which he had been suffering since the previous month. A laparatomy revealed that the abdominal mass, found on physical examination, was a primary lesser omental tumor, histological examinations of which confirmed a diagnosis of leiomyosarcoma. The tumor cells showed a DNA diploid pattern. Leiomyosarcoma of the lesser sac is extremely unusual and it is important that it be distinguished from an extraluminal tumor of the abdomen.     

Primary leiomyosarcoma of the great saphenous vein: case report.

OBJECTIVE: To describe a case of primary leiomyosarcoma of the great saphenous vein. PATIENT RECORD: A 59-year-old Chinese lady presented with two painful lumps in the right thigh in the line of the great saphenous vein. At surgery, in September 2004, two tumors in the right great saphenous vein above the knee were excised with the intervening normal vein. Histopathological studies confirmed both masses as leiomyosarcoma. Radiotherapy was given postoperatively. The patient has been followed-up for 300 days after surgery with no evidence of local or distant metastasis. CONCLUSION: Leiomyosarcoma of the great saphenous vein can exist at more than one site. Tumor resection and radiotherapy was associated with good patient prognosis.     

Primary leiomyosarcoma of the great saphenous vein: A case report

Introduction and importanceVascular 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 presentationWe 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 discussionVascular 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.ConclusionPhysicians 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.     

Primary leiomyosarcoma of the innominate vein

Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.     

Internal jugular vein reconstruction using a superficial femoral vein graft.

Numerous methods of venous reconstruction have been described to help prevent the many complications related to bilateral ligation of the internal jugular veins. The authors report a case in which the superficial femoral vein was used as the donor graft for reconstruction of the internal jugular vein in a 61-year-old man who underwent a tonsillar commando procedure for cancer. The advantages of using this donor vein for reconstruction of the internal jugular vein are summarized.     

Successful reconstruction of stripped superficial femoral vein

A 69-year-old man who had hemorrhagic shock after inadvertent stripping of the right superficial femoral-popliteal vein during surgery for greater saphenous vein varicosis in another hospital was referred to us. Phlebography revealed a ruptured popliteal vein with intact profunda femoris and common femoral veins. The stripped superficial femoral-popliteal vein brought in a jar was reimplanted. Phlebography performed during the patient's follow-up visits in our outpatient clinic 11 months postoperatively showed a patent femoral vein.     

Primary leiomyosarcoma of the breast: report of a case

We describe herein a case of primary leiomyosarcoma of the breast in a 59-year-old woman. Preoperative clinical examination and cytology findings indicated a benign breast tumor, but intraoperative histopathological examination of the tumor revealed malignant spindle cells, and a modified radical mastectomy was performed. Immunohistochemical analysis subsequently confirmed a diagnosis of leiomyosarcoma. Primary leiomyosarcoma of the breast is extremely rare and difficult to diagnose before surgery because of the need for mitotic figures and immunohistochemical staining to confirm the diagnosis. When pre- and intraoperative examinations indicate the possibility of a leiomyosarcoma, an extended excision with sufficient margins should be performed to remove all of the affected tissue. A review of the literature on this unusual tumor of the breast is presented. Received: May 21, 2001 / Accepted: November 20, 2001     

Primary leiomyosarcoma of the greater omentum: a case report

IntroductionGreater omentum leiomyosarcomas are rare tumors with only a few cases reported in literature.Presentation of caseWe report the case of a 68-year-old man who consulted complaining of diffuse abdominal pain without a palpable mass at physical examination. Imaging studies revealed a solid-cystic lesion in the right lower quadrant. Surgical resection was performed and the tumor was diagnosed as a leiomyoscarcoma by histological and immunohistochemical examinations.DiscussionSurgical resection of all lesions seems to be a reasonable therapeutic approach if resection is feasible. Chemotherapy may be used in selected cases.ConclusionMore cases are needed to define the best treatment approach of this disease.     

原发性T10脊椎平滑肌肉瘤1例

平滑肌肉瘤是多见于腹膜后隙、腹腔内脏器以及肢体皮下组织的恶性肿瘤,原发于骨的平滑肌肉瘤少见,而原发于脊往的平滑肌肉瘤更少见,笔者只检索到2例报道。本院收治1例原发于T10的骨原发平滑肌肉瘤．报道如下。     

Patency of superficial femoral vein employed as a crossover femoral artery bypass conduit

This study assesses the patency of superficial femoral vein used as a crossover femoral artery bypass conduit in patients presenting either with localized groin sepsis, generalized sepsis or in patients with occluded or heavily diseased superficial femoral artery outflow. Twenty patients were followed prospectively with femoral crossover grafts constructed of superficial femoral vein. Twelve patients presented with sepsis and 8 with chronic ischemia from iliac artery occlusion and severely diseased superficial femoral artery outflow. Graft patency was assessed with regular duplex ultrasound examination. There was one perioperative death. Six patients died during the follow-up period. Mean follow-up time was 24.3 months. No graft occluded or required revision. There was no limb loss, graft infection, or graft hemorrhage. Superficial femoral vein offers an effective femoral crossover bypass graft in patients with either localized/generalized sepsis or disadvantaged outflow tracts.     

Primary leiomyosarcoma of the left renal vein]

The authors report a case of leiomyosarcoma of the left renal vein. Because of its retroperitoneal position, this exceptional tumour was responsible for few symptoms. Complementary investigations (CT scan, ultrasonography, arteriography) often do not confirm the diagnosis. Complete surgical excision combined with complementary treatment can ensure long-term survival.     

Giant leiomyosarcoma of the remnant stomach: Report of a case

(Received for publication on Mar. 6, 1997; accepted on Nov. 6, 1997)     

In situ femoral to popliteal bypass graft using superficial femoral vein to popliteal vein

During the evolution of vascular surgery as a specialty, many conduits have been used to revascularize the lower extremities. Superficial veins and prosthetic materials make up the majority of materials used to bypass diseased segments of native artery. The deep veins of the thigh have also been reported as alternatives for arterial bypass. However, the use of the in situ superficial femoral and popliteal vein bypass has not been reported to our knowledge in current literature. We report a 79-year-old white female with lower extremity rest pain who underwent an in situ femoral popliteal bypass graft for limb salvage.