PREOPERATIVE CT AND MR-IMAGING OF INFERIOR VENA-CAVA LEIOMYOSARCOMA

We investigated the radiological findings of five patients with primar y leiomyosarcoma of the inferior vena cava (IVC) comparing cavography, computed tomography (CT), and magnetic resonance imaging (MRI). The r adiographic presentation ranged from an intraluminal lesion with obstr uction of the IVC to a tumor mass extending from the media musculature into the surrounding perivascular tissue with only slight protrusion into the lumen. The lesions were associated with late or few symptoms. Pathognomonic radiological findings could not be established. In case s with an extraluminal growth a lobulated, well-defined, encapsulated tumor with an inhomogeneous contrast uptake is characteristic in CT st udies. Additional information was provided by MRI. Leiomyosarcomas wit h extraluminal involvement showed homogeneous intermediate signal inte nsity (SI) on T1-, and mixed intermediate/high SI on T2-weighted image s. In cases with predominantly intraluminal growth, both CT and MRI de monstrated the IVC to be dilatated and allowed to differentiate betwee n tumor extent and obliterating thrombosis. Modern imaging modalities allow an early and accurate pre-operative diagnosis resulting in a hig her rate of surgical resection and improvement of survival.