Leiomyosarcoma of Inferior Vena Cava involving the Liver– A rare case report

Abstract

Sarcomas are very rare tumours and 10-30% are located in retro peritoneum. Out of all the sarcoma cases only 1% cases are of Leiomyosarcoma. We reported a case of 60 year female came with chief complaints of pain abdomen and loss of weight. On palpation there was tenderness in the right hypochondrium and was evaluated. MRI abdomen showed a well-defined heterogenous mass of size 8.8 ×7.9×8.2cm noted in the suprarenal location which was compressing inferiorvenacava (IVC) and also showed displacement of IVC with focal intraluminal extension with possibility of Leiomyosarcoma of IVC or retro peritoneum or hepato renal region. Section from trucut biopsy of Liver showed loss of normal liver architecture by pleomorphic spindle tumour cells arranged in bundles. Cells showing marked nuclear pleomorphism with enlarged irregular nucleus with many mononucleate and multi nucleate gaint cells suggestive of malignant spindle cell neoplasm. Immuno Histochemistry (IHC) staining was showed diffuse positivity for smooth muscle Actin, Desmin. Treatment was initiated with adjuvant chemotherapy. Later IVC reconstruction along with resection of supra renal mass was done. Keywords: Leiomyosarcoma of inferiorvenacava (IVC), Malignant spindle cell neoplasm of Liver.