Leiomyosarcoma of The Inferior Vena Cava

Retroperitoneal tumors are a clinical challenge, as the symptoms tend to be nonspecific and tumor growth insidious. As such, they are often diagnosed as large masses mainly using cross sectional imaging, such as CT and MRI. In some cases, sonographic imaging can also be a valuable tool for assessing such findings.

We report a case of a retroperitoneal mass in a 74-year-old woman who presented with mild chronic abdominal discomfort worsening over time, with no medical history to mention but controlled hypothyroidism. The woman underwent several imaging studies, including US, CT and MRI before reaching a diagnosis. After complete resection of the mass histological findings were compatible with leiomyosarcoma originating in the IVC.

Although the final diagnosis is made by histology, imaging plays a vital role in diagnosis and pre-operative planning including assessing adjacent organ involvement and resectability. This case emphasizes the clues and pitfalls of each imaging modality.