Suprarenal symplastic leiomyoma of the inferior vena cava

Primary leiomyoma of the inferior vena cava mimicking a cystic neoplasm of the pancreas: a case report

Benign smooth muscle tumors of the inferior vena cava (IVC) are unusual, but mostly consist of intravenous leiomyomatosis, which arises from the uterus. Primary leiomyoma of the IVC is extremely rare. Here, we report a primary leiomyoma of the IVC, misleadingly reported as a cystic neoplasm of the pancreas in images. Immunohistochemical analysis was positive for (estrogen receptor) ER and (progesterone receptor) PR, indicating gynecologic leiomyomas. The use of ER and PR immunostaining is recommended to help distinguish between somatic and gynecologic leiomyomas, whose criteria of malignancy differ.

Primary inferior vena cava smooth muscle tumor with diffuse bizarre giant nuclei and low mitotic rate: a nomenclatural conundrum

A male patient with obstructive jaundice was found to have an incidental nodule within the inferior vena cava (IVC), below the level of the renal vein, on abdominal imaging. At the time of the Whipple's procedure for pancreatic adenocarcinoma, the IVC mass measuring 3.4×2.7×2.2 cm was also removed. Histologically, the lesion was well circumscribed, composed focally of spindle-shaped cells with cigar-shaped nuclei reminiscent of smooth muscle and a dominant pervasive, pleomorphic, bizarre giant cell component. Two mitoses per 10 high-power fields were identified in the most mitotically active area of the entire tumor, with the vast majority of the tumor being mitotically inert. Additionally, no evidence of coagulative necrosis was noted. The bizarre giant cells had multi- and polylobated configurations, and several were replete with nuclear pseudoinclusions. Both the spindle cell and pleomorphic components displayed strong immunoreactivity for all smooth muscle markers. This lesion conformed morphologically to a smooth muscle tumor with bizarre nuclei or so-called symplastic/bizarre leiomyoma, as encountered in the uterus. However, current thinking based on location in the IVC and the presence of any mitotic activity with cellular atypia makes this lesion a leiomyosarcoma. Perhaps more pragmatic terminology would be smooth muscle tumor with bizarre nuclei and low malignant potential since the limited number of cases described thus far appear to have a more indolent course.

Leiomyoma Originated From Inferior Vena Cava Mimicking an Adrenal Malignant Tumor on 18F-FDG PET/CT

PET/CT was performed on an asymptomatic 62-year-old woman with a suspected adrenal mass and revealed the lesion with high F-FDG avidity and inferior vena cava involvement. A malignant nonfunctioning adrenal tumor was suspected. However, histopathology of the resected lesion revealed a leiomyoma arising from the inferior vena cava.

Symplastic leiomyoma in the suprarenal inferior vena cava

Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC.

Symplastic leiomyoma of uterus--a clinico-pathological dilemma

The diagnosis of uterine smooth muscle tumours is usually not difficult. Occasionally, benign tumours with an unusual histopathology may cause some dilemma for clinicians who had not experienced such report before. A 50-year-old female patient was admitted to our gynaecology clinics with lower abdominal heaviness and urinary symptoms and undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy with a probable diagnosis of cervical fibroid. Histopathological examination showed lipoleiomyoma uterus with focal symplastic features. This case report describes the clinic-pathological dilemma in managing the patient with symplastic leiomyoma of the uterus.