H1650/2000 Vascular Leiomyosarcoma

• arising from the walls of arteries and veins
• most common in large veins such as vena cave
• excessively rare in systemic arteries

Inferior vena cava leiomyosarcoma

• 80-90% IVC tumours in women
• in other veins affects sexes equally
• symptoms and resectability depenent on level
• suprahepatic tumours - Budd-Chiari, unresectable
• mid-level tumour - renal impairment, some resectable
• below renal vein - lower leg oedema, often resectable

Criteria of malignancy
(different from uterine location)

• 5 mitosis per 10 hpf
• necrosis
• overly large ( > 10 cm )
• haemorrhages
• nuclear pleomorphism

Prognosis

• tumour size
• mitotic rate
• depth
• location (resectability)

About half have metastases at diagnosis
Stuart & Baker : 5 of 10 patients followed up longer than 1 year. All died.