Travelling from the Inferior Vena Cava to the Right Atrium Braving All Odds: A Case of Retroperitoneal Leiomyosarcoma of the Inferior Vena Cava

Leiomyosarcoma (LMS) of the inferior vena cava (IVC), although rare, is the most common primary tumour of the IVC. Due to a vague, non-specific clinical presentation, radiological investigations play an important role in diagnosis. The tumours are classified based on the segment of the IVC involved and the growth pattern. The authors report a case of a 41-year-old man who presented with complaints of pain in the right hypochondrium, abdominal distension, and occasional episodes of fever for 1 month. Imaging features showed a well-defined, lobulated, heterogeneous lesion in the retroperitoneum invading the IVC, causing its expansion. There was an extension into the right atrium. Histopathological findings confirmed the diagnosis of an LMS. Surgery is the mainstay of treatment for such tumours. This case highlights the imaging features of a retroperitoneal LMS involving the IVC, causing its expansion and extension into the right atrium.