Leiomyosarcoma of the great saphenous vein (vena saphena magna) with granular cell change: Report of a superficial neoplasm

Great saphenous vein leiomyosarcoma mimicking thrombosed aneurysm: A case report and review of the literature

Vascular leiomyosarcoma LMS. is an extremely rare subgroup of LMSs. Fewer than 50 cases of LMS originating from the great saphenous vein have been reported. In 43% of reported cases, LMS was misdiagnosed clinically. In our case, the patient was initially misdiagnosed as having a thrombosed aneurysm. This misdiagnosis could be due to the rarity of great saphenous vein LMS cases, for which a high index of suspicion is needed, and because no specific radiologic findings have been established for diagnosing LMSs. Masses presenting along the course of vessels should be suspected for malignancy, which can be helpful in performing definitive surgery and avoiding multiple surgeries.

Primary leiomyosarcoma of the great saphenous vein: A case report

Introduction and importance

Vascular smooth muscle sarcomas are rare neoplasms that comprise less than 2% of all leiomyosarcomas. These malignancies usually originate in the inferior vena cava, with a limited number of cases affecting the great saphenous vein. Due to the limited reports on these sarcomas, epidemiologic data remains insufficient.

Case presentation

We report the case of a 67-year-old Hispanic female that presented with an asymptomatic growing mass in her right thigh. She was managed with an En bloc resection under the impression of a smooth muscle vascular sarcoma. The diagnosis was confirmed after histopathologic evaluation.

Clinical discussion

Vascular leiomyosarcomas remain a rare and challenging diagnosis. They usually present as a slowly growing mass that is initially asymptomatic. High clinical suspicion and a comprehensive radiologic evaluation, including magnetic resonance imaging, are crucial. Histopathological evaluation is essential for diagnostic confirmation. Surgical excision remains the treatment of choice, with radiation therapy mostly considered for local disease control. Postsurgical surveillance is necessary every three months to monitor for signs of recurrence.

Conclusion

Physicians should remain aware of the nonspecific presentation of leiomyosarcomas and the importance of a comprehensive diagnostic approach. Early diagnosis and adequate management are fundamental elements in the treatment of these aggressive tumors.

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Consider leiomyosarcoma within the differential diagnosis of a painless enlarging mass.

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Doppler ultrasound and magnetic resonance imaging are valuable diagnostic tools.

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Data support radiation therapy for local control of these neoplasms.

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This case contributes to the limited literature regarding the epidemiology and treatment of these tumors.

Metastasizing Malignant Granular Cell Tumor (Abrikossoff Tumor) of the Anterior Abdominal Wall, with Prolonged Survival

Malignant granular cell tumor (MGCT) is a rare high-grade mesenchymal tumor of Schwann cell origin. MGCTs commonly affect thigh, extremity, and trunk; however, involvement of the abdominal wall is quite rare. It has poor prognosis with 39% mortality rate in 3-year interval. We report a 50-year-old female who had MGCT arising in the anterior abdominal wall and developed massive metastatic deposits in both lungs and in the right inguinal lymph nodes, with prolonged survival for 11 years. A brief review of the literature is presented.