Great Saphenous Vein and Leiomyosarcoma

Introduction: The authors report a rare case of a leiomyosarcoma of the great saphenous vein (GSV), diagnosed in a 72-year-old male. Report: The symptoms were limited to leg tension and pain during exercise; Duplex scan suggested a GSV thrombosis with an enlarged lymph node. The failure of low-molecular-weight heparin treatment requested a magnetic resonance imaging (MRI) scan revealing a mass attached to the left saphenous vein. An en bloc removal of the mass, measuring 5.5cm in diameter, and a wide resection was performed; a furtherrevision was necessary after 2 months in order to perform radical surgery and the patient underwentradiation therapy. When lung metastases occurred, the patient started chemotherapy but after 5 months died. Discussion: Leiomyosarcoma is difficult to diagnose, requiring MRI scan or positron emission tomography-computed tomography (PET-CT) scan. The best therapy is surgery, which must be radical and may be followed by radiation therapy that may be indicated postoperatively in case of metastases. © 2013 European Society for Vascular Surgery.