What question did this study set out to answer?

To present a rare case of venous leiomyosarcoma initially diagnosed as chronic deep vein thrombosis and its management.

April 12, 2026MedicineOpen Access

Primary leiomyosarcoma originating from the deep femoral vein initially presenting as chronic deep vein thrombosis: A case report and review of literature

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Key result

Deep femoral vein leiomyosarcoma mimics chronic DVT, necessitating multimodal imaging when symptoms persist despite anticoagulation.

Why the study?

Venous leiomyosarcoma is an uncommon subtype of aggressive smooth muscle tumor, with the majority of cases involving the vena cava rather than peripheral veins.

Key Points

To present a rare case of venous leiomyosarcoma initially diagnosed as chronic deep vein thrombosis and its management.
Case report on a 56-year-old patient presenting with symptoms of DVT.
Utilized duplex ultrasound, contrast-enhanced CT, MRI, and PET-CT for diagnosis.
Performed surgical resection and reconstruction of the femoral vein using a graft.
Conducted histopathologic examination to confirm the diagnosis.
Initial misdiagnosis of DVT due to persistent leg edema despite anticoagulation.
Imaging revealed an increasing intraluminal mass, eventually diagnosed as VLMS.
Postoperative recovery was uneventful, with subsequent referral for chemotherapy and radiotherapy.

Structured PICO

Population

1 56-year-old patient initially diagnosed as deep vein thrombosis (DVT) in the common femoral vein who was later diagnosed with primary venous leiomyosarcoma (VLMS) originating from the deep femoral vein.

Intervention

Surgical resection of the mass, followed by reconstruction of the femoral vein using an expanded polytetrafluoroethylene graft, and referral for adjuvant chemotherapy and radiotherapy.

This case highlights the need for a high level of suspicion and multimodal imaging when DVT presents with atypical features or persists despite anticoagulation, to rule out rare neoplasms like venous leiomyosarcoma.

Discussion

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Implication

Warrants high suspicion and multimodal imaging in persistent DVT despite anticoagulation; extends differential to include primary venous leiomyosarcoma.

Cite This Study

Jang et al. (2026) studied this question. Primary venous leiomyosarcoma originating from the deep femoral vein can mimic chronic deep vein thrombosis, necessitating multimodal imaging when symptoms persist despite anticoagulation therapy.

synapsesocial.com/papers/69db380f4fe01fead37c63c2 https://doi.org/10.1097/md.0000000000048155

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Implication

Warrants high suspicion and multimodal imaging in persistent DVT despite anticoagulation; extends differential to include primary venous leiomyosarcoma.

Primary leiomyosarcoma originating from the deep femoral vein initially presenting as chronic deep vein thrombosis: A case report and review of literature

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Primary leiomyosarcoma originating from the deep femoral vein initially presenting as chronic deep vein thrombosis: A case report and review of literature

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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