[Leiomyosarcoma Originating from the Renal Vein-A Case Report]

Area of Science:

• Oncology
• Vascular Surgery
• Pathology

Background:

• Leiomyosarcoma is a rare soft tissue sarcoma, with vascular origin being particularly uncommon.
• Renal vein leiomyosarcoma is a rare subtype, distinct from more common inferior vena cava origins.
• This case presents a diagnostic and surgical challenge due to the tumor's location and infiltration.

Purpose of the Study:

• To report a rare case of leiomyosarcoma originating from the renal vein.
• To describe the diagnostic imaging and histopathological findings.
• To highlight the successful surgical management and outcomes of this rare vascular tumor.

Main Methods:

• Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) for tumor characterization.
• Surgical resection including left renal and retroperitoneal tumor resection.
• Histopathological examination and immunohistochemical staining (α-SMA, desmin) for diagnosis.

Main Results:

• Imaging revealed an irregular 7 cm mass at the left renal hilum with central necrosis, infiltrating the renal pelvis and ureter.
• Histopathology confirmed leiomyosarcoma with spindle and polyrhomboidal cells, continuous with the renal vein wall.
• Immunohistochemistry showed positivity for α-SMA and weak positivity for desmin.
• The patient remained disease-free with no recurrence or metastasis at 1-year post-surgery.

Conclusions:

• Renal vein leiomyosarcoma is a rare entity requiring a high index of suspicion.
• Multimodal imaging and detailed histopathology are crucial for diagnosis.
• Complete surgical resection offers a favorable prognosis, even in rare vascular sarcoma cases.