Abstract
Background
Leiomyosarcoma (LMS) is a rare malignant tumor of smooth muscle origin that generally stems from soft tissues and uterine tissue. However, a small percentage of this sarcoma subset may originate from the smooth muscle of vessel walls, most of which are of venous origin. Although the vena cava (VC) serves as the most likely source for these tumors and has been well described in the literature, there is limited information focused on non-VC LMS derived from large veins. The focus of this study was to consolidate the reports and previously published data of all non-VC LMS of venous origin to better characterize and describe this disease process.
Methods
We reviewed information derived from 143 previously published cases.
Results and Conclusions
It was determined that women aged 60–69 years were most commonly diagnosed with this particular type of tumor, with the most common tumor site being the renal vein. Metastasis was present in 12 % of this population at the time of diagnosis, and 32 % of patients were alive 4 years later.
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References
Caldarelli GF, Barellini L, Faviana P, Guerra M. Leiomyosarcoma of the popliteal artery: case report and review of the literature. J Vasc Surg. 2003;37:206–9.
Dzsinich C, Gloviczki P, van Heerden JA, et al. Primary venous leiomyosarcoma: a rare but lethal disease. J Vasc Surg. 1992;15:595–603.
Wang TS, Ocal IT, Salem RR, et al. Leiomyosarcoma of the adrenal vein: a novel approach to surgical resection. World J Surg Oncol. 2007;5:109.
Berlin O, Stener B, Kindblom LG, Angervall L. Leiomyosarcomas of venous origin in the extremities. A correlated clinical, roentgenologic, and morphologic study with diagnostic and surgical implications. Cancer. 1984;54:2147–59.
Dasika U, Shariati N, Brown JM 3rd. Resection of a leiomyosarcoma of the azygos vein. Ann Thorac Surg. 1998;66:1405.
Levett JM, Meffert WG, Strong WW, et al. Leiomyosarcoma of the superior vena cava and azygos vein. Ann Thorac Surg. 1995;60:1415–7.
Illuminati G, Miraldi F, Mazzesi G, et al. Primary leiomyosarcoma of the innominate vein. Ann Vasc Surg. 2007;21:75–8.
Tilkorn DJ, Lehnhardt M, Hauser J, et al. Intravascular leiomyosarcoma of the brachiocephalic region—report of an unusual tumour localisation: case report and review of the literature. World J Surg Oncol. 2008;6:113.
Forte A, Leonetti G, Bosco M, et al. Leiomyosarcoma of brachiocephalic vein: case report. G Chir. 2006;27:381–3.
Fu TY, Hsieh PP, Chen LW, et al. Leiomyosarcoma of the cephalic vein: case report and review of the literature. Ann Vasc Surg. 2007;21:508–11.
Jefferson KP, Dixon JH. Leiomyosarcoma of the cephalic vein. Sarcoma. 2001;5:27–30.
Abed R, Abudu A, Grimer RJ, et al. Leiomyosarcomas of vascular origin in the extremity. Sarcoma. 2009;2009:385164.
Propper B, Zonies D, Smith D, Rasmussen TE. Autogenous arterial and venous reconstruction for femoral vein leiomyosarcoma—a case report. Vasc Endovascular Surg. 2009;43:215–20.
Shindo S, Katsu M, Kaga S, et al. Leiomyosarcoma of a femoral vein misdiagnosed as deep vein thrombosis. J Vasc Interv Radiol. 2009;20:689–91.
Subramaniam MM, Martinez-Rodriguez M, Navarro S, et al. Primary intravascular myxoid leiomyosarcoma of the femoral vein presenting clinically as deep vein thrombosis: a case report. Virchows Arch. 2007;450:235–7.
Bashir EA, Anwar SF. Leiomyosarcoma of femoral vein in an adult. J Coll Physicians Surg Pak. 2005;15:656–7.
Roy C, Beaujeux R, Mutter D. Leiomyosarcoma of the femoral vein: imaging findings. AJR Am J Roentgenol. 1993;160:1125–6.
Gonzalez EB. Leiomyosarcoma of iliac and femoral veins. Arch Surg. 1965;91:623–4.
Reix T, Sevestre H, Sevestri-Pietri MA, et al. Primary malignant tumors of the venous system in the lower extremities. Ann Vasc Surg. 1998;12:589–96.
Song KY, Jang YW, Kim MK, et al. Leiomyosarcoma arising in the great saphenous vein—a case report. J Korean Med Sci. 1991;6:372–5.
Stringer BD. Leiomyosarcoma of artery and vein. Am J Surg. 1977;134:90–4.
Allison MF. Leiomyosarcoma of the femoral vein. report of a case in a child. Clin Pediatr (Phila). 1965;4:28–31.
Christiansen J. Malignant tumors originating from the venous system. Review and a case of leiomyosarcoma from the long saphenous vein. Ugeskr Laeger. 1964;126:483–5.
Fischer MG, Gelb AM, Nussbaum M, et al. Primary smooth muscle tumors of venous origin. Ann Surg. 1982;196:720–4.
Hughes S. A case of leiomyosarcoma of the long saphenous vein. Vasc Surg. 1973;7:71–3.
Stallard D, Sundaram M, Johnson FE, Janney C. Case report 747. Leiomyosarcoma of great saphenous vein. Skeletal Radiol. 1992;21:399–401.
Marle AG, Bronkhorst MW, Brouwers MA. Leiomyosarcoma of the great saphenous vein: a case report and review of the literature. Sarcoma. 2004;8:135–9.
El Khoury M, Mesurolle B, Trassard M, et al. Leiomyosarcoma of the great saphenous vein. Australas Radiol. 2006;50:500–3.
Mammano E, Zanon A, Picchi G, et al. Primary great saphenous vein leiomyosarcoma: report of a case. Surg Today. 2008;38:161–2.
Szasz IJ, Barr R, Scobie TK. Leiomyosarcoma arising from veins: two cases and a review of the literature on venous neoplasms. Can J Surg. 1969;12:415–9.
Byard RW, Bourne AJ, Phillips GE, et al. Leiomyosarcoma of the saphenous vein in a child with 12-year follow-up. J Pediatr Surg. 1993;28:271–4.
Saglik Y, Icli F, Uluoglu O, Isiklar ZU. Leiomyosarcoma of the great saphenous vein. Int Orthop. 1992;16:185–7.
Gross E, Horton MA. Leiomyosarcoma of the saphenous vein. J Pathol. 1975;116:37–41.
Welk E, Bindewald H, Berndt R. Vascular leiomyosarcoma—a surgical rarity. Chirurg. 1991;62:223–5.
Zhang XS, Wang ZG. Primary leiomyosarcoma of the great saphenous vein: case report. Eur J Vasc Endovasc Surg. 2006;32:222–5.
Humphrey M, Neff J, Lin F, Krishnan L. Leiomyosarcoma of the saphenous vein. A case report and review of the literature. J Bone Joint Surg Am. 1987;69:282–6.
Smout MS, Fisher JH. Leiomyosarcoma of the saphenous vein. Can Med Assoc J. 1960;83:1066–7.
Camiade C, Deplas A, Soyer J, et al. Iliac venous leiomyosarcoma revealed by cruralgia: a case report. Ann Chir. 2002;127:142–5.
Lawrence MS, Crosby VG, Ehrenhaft JL. Leiomyosarcoma of the right iliac vein: case report. Ann Surg. 1966;164:924–6.
Prandi M, Scabini S, Taviani MP. An extraluminal leiomyosarcoma of the iliac vein without thrombosis—a case report. Vasc Surg. 2001;35:311–4.
Fung TM, Wong WS, Lam YH, Lau JY. Resection of leiomyosarcoma arising from the iliac vein. J Am Coll Surg. 2005;200:136–7.
Valverde FM, Ramos MJ, Torregrosa N, et al. Leiomyosarcoma of the iliac vein. Ann Vasc Surg. 2009;23:536 e535–8.
Biasi G, Gonano N, Santarelli R, et al. Leiomyosarcoma of the great veins: a case involving the left iliac vein extending to the inferior vena cava. Phlebologie. 1993;46:501–5.
Choquart P, Leclerc JP, Modigliani R, et al. Leiomyosarcoma of the inferior mesenteric vein. Ann Chir. 1976;30:161–3.
Chiarugi M, Pressi E, Mancini R, et al. Leiomyosarcoma of the right ovarian vein. Am J Surg. 2009;197:e36–7.
Cho HJ, Kim HK, Suh JH, et al. Leiomyosarcoma of the ovarian vein: a case report with radiological findings. Korean J Radiol. 2008;9(Suppl):S14–7.
Honore LH, Robins RE, Taylor RH. Leiomyosarcoma of the right ovarian vein a case report. Angiology. 1977;28:285–8.
Iannelli A, Karimdjee BS, Fabiani P, et al. Leiomyosarcoma of the ovarian vein: report of a case. Int Surg. 2003;88:6–8.
Kawai K, Horiguchi H, Sekido N, et al. Leiomyosarcoma of the ovarian vein: an unusual cause of severe abdominal and flank pain. Int J Urol. 1996;3:234–6.
Kaufman JL. Leiomyosarcoma of the popliteal vein. Arch Surg. 1987;122:119.
Killoran TP, Wells WA, Barth RJ, Goodwin DW. Leiomyosarcoma of the popliteal vein. Skeletal Radiol. 2003;32:174–8.
Baljozovic AD. Leiomyosarcoma of the axillary vein. Srp Arh Celok Lek. 1969;97:1105–9.
Wilson SR, Hine AL. Leiomyosarcoma of the portal vein. AJR Am J Roentgenol. 1987;149:183–4.
Madariaga JR, Nalesnik MA, Iwatsuki S, et al. Spindle cell tumor of the portal vein. J Surg Oncol. 1995;59:139–41.
Leone O, Piana S, Cenacchi G, et al. Leiomyosarcoma of the pulmonary vein: case report with immunohistochemical and ultrastructural findings. Gen Diagn Pathol. 1997;142:235–40.
Gonzalez-Campora R, Rubi-Uria J, Mora-Marin J, et al. Pulmonary vein myxoid leiomyosarcoma. Pathol Res Pract. 1989;185:900–4.
Gyhra AS, Santander CK, Alarcon EC, et al. Leiomyosarcoma of the pulmonary veins with extension to the left atrium. Ann Thorac Surg. 1996;61:1840–1.
Ko TM, Mayer DA, Tsapogas MJ, et al. Leiomyosarcoma of the pulmonary vein. J Cardiovasc Surg (Torino). 1996;37:421–3.
Burke AP, Virmani R. Sarcomas of the great vessels. A clinicopathologic study. Cancer. 1993;71:1761–73.
Shimono T, Yuasa H, Yuasa U, et al. Pulmonary leiomyosarcoma extending into left atrium or pulmonary trunk: complete resection with cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1998;115:460–1.
Oliai BR, Tazelaar HD, Lloyd RV, et al. Leiomyosarcoma of the pulmonary veins. Am J Surg Pathol. 1999;23:1082–8.
Cordes BG, Collins BT, McDonald JW, et al. Fine needle aspiration biopsy of primary leiomyosarcoma arising from a pulmonary vein. Acta Cytol. 1999;43:523–6.
Okuno T, Matsuda K, Ueyama K, et al. Leiomyosarcoma of the pulmonary vein. Pathol Int. 2000;50:839–46.
Kidd BS, Carson DJ, Lamont ES. Intra-atrial sarcoma. Br Med J. 1961;2:1476–8.
Khemichian S, Bemanian S. Pulmonary vein leiomyosarcoma. Intern Med J. 2006;36:793–4.
Akamine S, Uchiyama Y, Kimino K, et al. Two cases of pulmonary leiomyosarcoma. Nippon Kyobu Geka Gakkai Zasshi. 1990;38:1203–8.
Gurbuz A, Yetkin U, Yilik L, et al. A case of leiomyosarcoma originating from pulmonary vein, occluding mitral inflow. Heart Lung. 2003;32:210–4.
Grignon DJ, Ro JY, Papadopoulos NE, Ayala AG. Leiomyosarcoma of renal vein. Urology. 1991;38:255–8.
Martin B, Roche A, Menu Y. Radiologic diagnosis of leiomyosarcomas of the renal vein: the role of angiography. A review of the literature apropos of 2 new cases. J Radiol. 1986;67:789–95.
Martin J, Garcia M, Duran A, et al. Renal vein leiomyosarcoma: a case report and literature review. Urol Radiol. 1989;11:25–9.
Brandes SB, Chelsky MJ, Petersen RO, Greenberg RE. Leiomyosarcoma of the renal vein. J Surg Oncol. 1996;63:195–200.
Bhathena D, Vazquez M. Primary renal vein leiomyosarcoma. Cancer. 1972;30:541–4.
Montgomery EM, Litvak AS, McRoberts JW. Leiomyosarcoma of renal vein. Urology. 1976;8:215–7.
Gierson ED, Rowe JH. Renal vein leiomyosarcoma. Am Surg. 1976;42:593–4.
Ball AB, Fisher C. Leiomyosarcoma of the renal vein: a report of two cases. Eur Urol. 1990;18:150–2.
Herman C, Morales P. Leiomyosarcoma of renal vein. Urology. 1981;18:395–8.
Inoue K, Watanabe H, Ohashi Y, et al. Leiomyosarcoma of the renal vein: a case report. J Urol. 1994;152:153–5.
Lipton M, Sprayregen S, Kutcher R, Frost A. Venous invasion in renal vein leiomyosarcoma: case report and review of the literature. Abdom Imaging. 1995;20:64–7.
Lemos GC, El Hayek OR, Apezzato M. Leiomyosarcoma of the renal vein. Int Braz J Urol. 2003;29:43–4.
Lakhloufi A, Khaiz D, Abi F, Bouzidi A. Primary leiomyosarcoma of the left renal vein. Ann Urol (Paris). 1992;26:333–5.
Pelton JJ, Palazzo JP, Peterson RO, Eisenberg BL. Renal vein leiomyosarcoma. J Surg Oncol. 1990;45:131–3.
Appell RA, Thistlethwaite JR. Leiomyosarcoma of renal vein. Urology. 1977;9:680–1.
Radhakrishanan J, Alrenga DP, Ghosh BC. Isolated hepatic metastasis from renal vein leiomyosarcoma. Arch Pathol Lab Med. 1978;102:606.
Aguilar IC, Benavente VA, Pow-Sang MR, et al. Leiomyosarcoma of the renal vein: case report and review of the literature. Urol Oncol. 2005;23:22–6.
Mansencal N, El Hajjam M, Vieillard-Baron A, et al. Recurrent pulmonary embolism with non-mobile thrombus in a patient with leiomyosarcoma of the left renal vein. Int J Cardiol. 2006;112:247–8.
Dufour B, Choquenet C, Nacash G. Primary leiomyosarcoma of the right renal vein with extension into the inferior vena cava. J Urol (Paris). 1982;88:561–5.
Farges O, Gugenheim J, Pascal G, et al. Primary leiomyosarcoma of the renal vein. Ann Chir. 1986;40:493–7.
Phoa SS, van Rooij WJ, Kox C, Dijkstra PF. Leiomyosarcoma of the suprarenal and renal veins, report on two cases. Rofo. 1988;148:84–5.
Varela-Duran J, Oliva H, Rosai J. Vascular leiomyosarcoma: the malignant counterpart of vascular leiomyoma. Cancer. 1979;44:1684–91.
Vos P, Barwegen MG, Bakker HH, et al. Leiomyosarcoma of the renal vein: a case report. J Urol. 1988;139:1042–4.
Farah MC, Shirkhoda A, Ellwood RA, et al. Leiomyosarcoma of the renal vein: radiologic pathologic correlation. Clin Imaging. 1989;13:323–6.
Maeda T, Tateishi U, Fujimoto H, et al. Leiomyosarcoma of the renal vein: arterial encasement on contrast-enhanced dynamic computed tomography. Int J Urol. 2006;13:611–2.
Kaufman JJ, Gelbard M. Leiomyosarcoma of renal vein and inferior vena cava. Urology. 1981;18:173–6.
Gow CH, Liaw YS, Chang YL, et al. Primary vascular leiomyosarcoma of the femoral vein leading to metastases of scalp and lungs. Clin Oncol (R Coll Radiol). 2005;17:201.
Paraskevas N, Castier Y, Dauge MC, et al. A rare case of leiomyosarcoma arising from a femoral vein tributary: a case report. Vasc Med. 2009;14:149–51.
Kuma S, Utsunomiya T, Yano S, et al. Leiomyosarcoma originating from the superior mesenteric vein: a case report and review of the literature. Ann Vasc Surg. 2008;22:453–5.
Celdran A, Frieyro O, del Rio A, et al. Leiomyosarcoma of the portal venous system: a case report and review of literature. Surgery. 2004;135:455–6.
Rodl W, Hofmann-Preiss K. Leiomyosarcoma of the splenic vein. Radiologe. 1988;28:42–4.
Goldin SB, Webb TH, Lillemoe KD. Leiomyosarcoma arising from the superior mesenteric vein. Surgery. 2002;132:108–9.
Leporrier J, Alkofer B, Lebreton G, et al. Leiomyosarcoma of the superior mesenteric vein: a diagnostic and therapeutic challenge. J Hepatobiliary Pancreat Surg. 2006;13:584–6.
Dorfman H FE. Leiomyosarcoma of the greater saphenous vein. Am J Clin Pathol. 1963;39:73–8.
Jernstrom P GR. Leiomyosarcoma of the long saphenous vein. Am J Clin Pathol. 1975;63:25–31.
VR A. Phlebosarcoma racemosum. Ned Tijdschr Geneeskde. 1919;63:759–67.
Hisa A HK, Kamioka N. A case of primary renal vein leiomyosarcoma. Med J Kochi Municipal Centre Hosp. 1984;11:53–7.
Clark MA, Thomas JM. Delay in referral to a specialist soft-tissue sarcoma unit. Eur J Surg Oncol. 2005;31:443–8.
Clark MA, Fisher C, Judson I, Thomas JM. Soft-tissue sarcomas in adults. N Engl J Med. 2005;353:701–11.
Hensley ML, Maki R, Venkatraman E, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;20:2824–31.
Sarcoma Meta-analysis Collaboration. Adjuvant chemotherapy for localised resectable soft-tissue sarcoma of adults: meta-analysis of individual data. Lancet. 1997;350:1647–54.
Kieffer E, Alaoui M, Piette JC, et al. Leiomyosarcoma of the inferior vena cava: experience in 22 cases. Ann Surg. 2006;244:289–95.
Mingoli A, Cavallaro A, Sapienza P, et al. International registry of inferior vena cava leiomyosarcoma: analysis of a world series on 218 patients. Anticancer Res. 1996;16:3201–5.
Hollenbeck ST, Grobmyer SR, Kent KC, Brennan MF. Surgical treatment and outcomes of patients with primary inferior vena cava leiomyosarcoma. J Am Coll Surg. 2003;197:575–9.
Hines OJ, Nelson S, Quinones-Baldrich WJ, Eilber FR. Leiomyosarcoma of the inferior vena cava: prognosis and comparison with leiomyosarcoma of other anatomic sites. Cancer. 1999;85:1077–83.
Hess DR. Retrospective studies and chart reviews. Respir Care. 2004;49:1171–4.
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Gage, M.J., Patel, A.V., Koenig, K.L. et al. Non-Vena Cava Venous Leiomyosarcomas: A Review of the Literature. Ann Surg Oncol 19, 3368–3374 (2012). https://doi.org/10.1245/s10434-012-2379-2
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DOI: https://doi.org/10.1245/s10434-012-2379-2