An unusual tumor in a rare localization: intravascular leiomyosarcoma of the cephalic vein. Case report.

Vascular leiomyosarcoma is a very rare soft tissue neoplasma, with a poor prognosis. We report a vascular leiomyosarcoma arising from an unusual site: the media-vascular wall of the cephalic vein. A 71-year-old man with a subcutaneous node on the volar side of right forearm, came to our attention with signs of vascular obstruction and venous stases, without functional or sensory loss of the right upper extremity. We successfully performed a surgical excision of the cancer with a wide margin resection. During surgery no ascellar lympnodes metastes were found. 4 months after surgery the wound had fully healed, and he suffered no effects by surgery, but he became lost to long-term follow-up and refused adjuvant radiotherapy or chemiotherapy. This case report shows that, in presence of venous stases or thrombosis signs of the upper extremity, leiomyosarcoma of the cephalic vein must be considered in the differential diagnosis among lung cancer, lymphoma or mesenchymal tumours.