Leiomyosarcoma of the Inferior Vena Cava: Review of the Literature and Report of Two Cases

Abstract

Six reports of primary tumors of the smooth muscle of the inferior vena cava were found during a thorough review of the pertinent medical literature. Two additional instances of leiomyosarcoma of this vein are described in this paper. The tumor in Case 1 involved the upper part of the inferior vena cava, and obstructed this vessel and the hepatic veins. There was conspicuous edema of the lower extremities and the lower part of the trunk, and also massive ascites. This represents the only published description of such a neoplasm with metastases, and these were multiple in the right and left lobes of the liver. The tumor extended into the right atrium, where it bacame adherent to and infiltrated the endocardium. Death was attributed to acute hepatic failure. The leiomyosarcoma in Case 2 was an unexpected finding at necropsy, and it involved the lower and middle thirds of the inferior vena cava in such a manner that there was complete obstruction of the vessel. Peripheral edema developed, but there was no ascites.