Qian Xu Jing, Girgis Safwat, Fingard Jordan, Wilson Mitchell P, Low Gavin
Department of Radiology & Diagnostic Imaging, University of Alberta Hospital, Edmonton, Canada.
Department of Laboratory Medicine & Pathology, Faculty of Medicine and Dentistry, University of Alberta Hospital, Edmonton, Canada.
Intractable Rare Dis Res. 2024 Nov 30;13(4):259-261. doi: 10.5582/irdr.2024.01037.
Inferior vena cava (IVC) leiomyosarcomas are rare smooth muscle neoplasms that account for 0.5% of adult soft tissue sarcomas. They present with nonspecific symptoms and have poor prognosis. We present a case of leiomyosarcoma arising from the retrohepatic IVC that was difficult to diagnose on imaging, showing similar characteristics to intrahepatic cholangiocarcinoma including heterogenous arterial phase enhancement and delayed enhancement on contrast-enhanced magnetic resonance imaging. Important differentiating features of IVC leiomyosarcomas on imaging include dilated IVC, imperceptible IVC lumen, and development of prominent venous collaterals. Despite this, imaging features may be similar to other retrohepatic mass etiologies so IVC leiomyosarcoma should be included in the differential diagnosis of any retrohepatic mass and biopsy should be pursued.
下腔静脉平滑肌肉瘤是罕见的平滑肌肿瘤，占成人软组织肉瘤的0.5%。它们表现为非特异性症状，预后较差。我们报告一例起源于肝后下腔静脉的平滑肌肉瘤，其在影像学上难以诊断，在对比增强磁共振成像上表现出与肝内胆管癌相似的特征，包括动脉期不均匀强化和延迟强化。下腔静脉平滑肌肉瘤在影像学上的重要鉴别特征包括下腔静脉扩张、下腔静脉管腔不可见以及显著静脉侧支循环的形成。尽管如此，影像学特征可能与其他肝后肿块病因相似，因此下腔静脉平滑肌肉瘤应纳入任何肝后肿块的鉴别诊断，且应进行活检。
