Summary
Leiomyosarcomas account for only 6 % of soft tissue tumours. 20 % of them are associated
with blood vessels, predominantly in the region of the inferior vena cava (1–4). It
is an extremely aggressive tumour that causes un-specific symptoms especially in the
lower extremities. In the absence of metastases, first-line treatment consists of
complete resection of the tumour with a safety margin. This has a positive effect
on the patient’s long-term survival (2, 5, 6). However, at the time of diagnosis more
than 50 % of patients already have pulmonary or hepatic metastases (1–3). Generally,
a multidisciplinary approach involving surgeons, pathologists, oncologists and radiologists
is required.
This case report describes a 74-year-old male patient with a local swelling on the
left proximal lower leg that had appeared about one year earlier. Histopathological
examination of a frozen section revealed a leiomyosarcoma with moderate differentiation.
Radical excision of the tumour with successful R0 resection was performed. No metastases
could be demonstrated in further staging using computed tomography (CT). Almost three
years after diagnosis, the patient is recurrence-free until now.
Keywords
Vascular leiomyosarcoma - inferior vena cava - frozen section technique - metastases
- staging
