Leiomyosarcoma in IVC

Primary sarcomas of heart or great vessels
: rare ( 1 % of all sarcoma)

Dismal prognosis, locally advanced or
metastatic disease at the time of initial diagnosis ( 5yr SR 38%, 10 Yr SR 14%)

Sarcoma in IVC  : leiomyosaroma 90%, angiosarcoma, rhadomyosarcoma

Women in the 5^소 and 6^소 decades

Tends to grow to a large size without
metastasis

Metastasis <50% liver, lung

Treatment 
Surgical resection

CT findings

Intermediate attenuation mass with
heterogenous enhancement

Intraluminal R11; expansion and obstruction of
IVC

Extraluminal R11; extrinsic compression and
proximal dilatation

DDx

Benign thrombosis

Secondary involvement of tumor ingrowth
from primary retroperitoneal neoplasm.

Imperceptible IVC sign L the most useful
sign

Angiosarcoma Most occur in RA, less common
involvement of the retroperitoneum especially the IVC