Case Report
Multiple primary cancers in a patient and CT scan features of inferior vena cava leiomyosarcoma: A case report
Muhammad Imran Butt1, Muhammad Asif Shahzad2
1Department of Medicine Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth WA 6009, Australia.
2Department of Medicine Lyell McEvin Hospital, Haydown Rd, Elizabeth Vale, SA 5112, Australia.


Address correspondence to:
Muhammad Imran Butt
Department of Medicine Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, Perth WA 6009

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Butt MI, Shahzad MA. Multiple primary cancers in a patient and CT scan features of inferior vena cava leiomyosarcoma: A case report. Int J Case Rep Images 2016;7(1):51–54.

Introduction: Primary inferior vena cava (IVC) sarcoma is a rare tumor of mesenchymal origin arising from the tunica media of inferior vena cava. It accounts for about 0.5% of all soft tissue sarcomas and there are less than 300 cases reported in literature [1][2]. It is the most common vascular sarcoma [3]. To the best of our knowledge, it has not been reported in combination with any other primary malignancy.
Case Report: An 86-year-old female with breast cancer presented with progressive development of bilateral lower limbs edema which was attributed to a palpable abdominal mass. Computed tomography scan revealed a large mass in her inferior vena cava (IVC) with features consistent with an IVC sarcoma. On PET scan, there was moderate grade heterogeneous activity related to the IVC mass, again suggestive of IVC sarcoma. Also, there was an intense uptake at gastroesophageal junction which was proven to be esophageal carcinoma on histology. Patient did not consent for biopsy of IVC lesion due to the risk involved in the procedure hence treated conservatively for edema with moderate improvement and received radiotherapy for esophageal carcinoma with good tolerance.
Conclusion: Multiple malignancies are uncommon and a long-term meticulous follow is required to diagnose second malignancy at early stage to reduce mortality rate. To our knowledge, this is the first ever case of this combination of primary malignancies with IVC sarcoma being a rare tumor.

Keywords: Inferior vena cava, Leiomyosarcoma, Multiple Primary cancers

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Author Contributions
Muhammad Imran Butt – Substantial contributions to conception and study design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Muhammad Asif Shahzad – Acquisition of data, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
Conflict of interest
Authors declare no conflict of interest.
© 2016 Muhammad Imran Butt et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.