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Primary leiomyosarcoma of the superior vena cava with massive thrombosis treated by local fibrinolysis

M. Marini E. Tovar ^* M. F. López-Fernández F. Pombo and E. Rodriguez

Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain ^* Department of Vascular Surgery, Hospital Juan Canalejo, La Coruña, Spain Department of Haematology, Hospital Juan Canalejo, La Coruña, Spain

This excerpt was created in the absence of an abstract.

Occlusion of the superior vena cava (SVC) is usually related to malignant or benign disease involving the mediastinum (Putnam et al, 1988) or secondary to central venous catheters and pacemakers (Capek & Cope, 1989). Acute superior vena cava syndrome (SVCS) caused by massive thrombosis secondary to leiomyosarcoma is a very rare event. Primary leiomyosarcoma of the SVC has been reported in only a few cases and special attention to radiological findings has been described in only two cases (Vogel et al, 1981; Lupetin et al, 1986).

We report a case of massive thrombosis of the SVC and its branches treated by local thrombolytic therapy that achieved complete lysis. Subsequently an intraluminal tumour mass was demonstrated on an enhanced computed tomographic (CT) study. Local fibrinolytic treatment should be given in SVCS due to thrombosis. The CT studies are of value in the search for the aetiology of SVCS. To our knowledge, this case is the first one in which the CT findings of leiomyosarcoma of the SVC are reported.

Key Words: Leiomyosarcoma • Superior vena cava • Neoplasm • Thrombolytic therapy • Computed tomography

Received for publication December 2, 1991. Accepted for publication August 10, 1992.

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