Leiomyosarcoma of the IVC

An extensive elongated heterogeneously enhancing mass lesion extending along the course inferior vena cava at infrahepatic, intrahepatic and suprahepatic course, protruding into the lumen of right atrium, measuring about 16 x 9.8 x 7.5 cm, inseparable from the IVC wall – of concern for primary leiomyosarcoma of the IVC.

 Differential considerations also include:- hepatocellular carcinoma with IVC extension

 Large extraluminal component of the mass infiltrating the pericaval hepatic parenchyma with invasion of hepatic veins .

 The inferior extent of the mass is noted at suprarenal level , sparing the renal veins

 Changes of liver cirrhosis with a hypodense rim enhancing mass lesion measuring about 1.8 x 1.6 cm is noted in left lobe – of concern for hepatic metastasis

 Small amount of free fluid in abdomen and pelvis associated with bunch of collateral vessels in the celiac, left suprarenal compartment of the retroperitoneum.