Primary Leiomyosarcoma of the Superior Vena Cava: A Rare Case Report.

Figures

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  Figure 1. Contrast-enhanced computed tomography reveals a hypervascular intraluminal mass occupying the superior vena cava and brachiocephalic vein. (A) The contrast-enhanced computed tomography shows a hypervascular intraluminal mass within the superior vena cava. (B) An axial computed tomography image demonstrates tumor extension into the brachiocephalic vein.

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  Figure 2. The figure shows the intraoperative view after reconstruction of the superior vena cava and brachiocephalic veins.

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  Figure 3. Histopathological and immunohistochemical features confirm a spindle cell neoplasm with smooth muscle differentiation and moderate proliferative activity. (A) Histopathological examination shows intersecting fascicles of spindle cells with moderate pleomorphism. Hematoxylin and eosin staining at ×100 demonstrates fascicular architecture of spindle-shaped tumor cells with infiltration of the venous wall. (B) Hematoxylin and eosin staining at ×400 shows spindle cell morphology, moderate pleomorphism, and mitotic figures (9 per 10 high-power fields). (C) Immunohistochemistry for smooth muscle actin at ×200 reveals diffuse cytoplasmic positivity, indicating smooth muscle differentiation. (D) Immunohistochemistry for Ki-67 at ×200 shows a proliferation index of approximately 35%, indicating moderate proliferative activity.