Key result
Thoracoscopic resection followed by radiotherapy successfully treated a 70-year-old male with a rare primary leiomyosarcoma of the azygos vein, with no recurrence observed at 7 months.
Why the study?
Primary mediastinal leiomyosarcomas are extremely rare, with high recurrence and metastatic potential making accurate and timely diagnosis critical.
Case Report (n=1)
No
Primary leiomyosarcoma of the azygos vein is a rare mediastinal tumor that should be considered in the differential diagnosis of mediastinal masses to optimize surgical planning.
May warrant leiomyosarcoma inclusion in spindle-cell mediastinal differentials; leaves open management guidance pending larger series.
Leiomyosarcomas are uncommon mesenchymal neoplasms. Primary mediastinal leiomyosarcomas are even rarer with only a limited number of cases reported. Given the high potential for recurrence and metastasis, accurate and timely diagnosis become extremely crucial for treatment. Herein, we present a unique case of a 70-year-old asymptomatic male patient with a primary leiomyosarcoma originating from the azygos vein, which was misdiagnosed as a tracheal tumor preoperatively. This report highlights the critical importance of including leiomyosarcoma in the differential diagnosis of mediastinal masses, especially when preoperative pathological findings indicate a spindle cell neoplasm of smooth muscle origin. Early recognition can more effectively assess intraoperative risks, optimize the surgical plan, and are essential to prevent locally invasive growth and potential metastasis. By analyzing the specific case and reviewing relevant literature, this study seeks to enhance our understanding of the diagnosis and treatment of primary mediastinal leiomyosarcoma, derive insights from our clinical experience, and emphasize the importance of maintaining suspicion and prudence among healthcare professionals.
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Zhu et al. (2025) conducted a case report in Primary leiomyosarcoma originating from the azygos vein (n=1). Thoracoscopic resection and postoperative radiotherapy was evaluated on Recurrence. Thoracoscopic resection followed by radiotherapy successfully treated a 70-year-old male with a rare primary leiomyosarcoma of the azygos vein, with no recurrence observed at 7 months.
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