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Abstract:

Background: leiomyosarcoma of veins is a rare group of sarcomas of mesenchymal origin, which develops from smooth muscle cells of vascular . Vascular leiomyosarcoma occurs in 2-5% and have a slow growth. It is rather difficult to diagnose this disease on the basis of only clinical symptoms, most often patients are worried about oedema and pain in lower limbs. To establish the diagnosis, it is necessary to use data of instrumental methods of examination, such as ultrasound, magnetic resonance imaging (MRI) and multispiral computed tomography (MSCT) with intravenous contrast enhancement, which allow to determine the tumor localization, prevalence, involvement of the vessel wall in the process, as well as to exclude distant metastases. The final diagnosis is made according to immunohistochemical studies.

Aim: was to study the importance of radiadiagnostics methods in case of such rare disease as leiomyosarcoma of the external iliac vein.

Material and methods: 67-year-old woman with complaints of oedema of the lower limb, was examined: an ultrasound study of inferior vena cava and veins of lower limbs, magnetic resonance imaging (MRI) and multispiral computed tomography (MSCT) with contrast enhancement, fine-needle aspiration biopsy Patient underwent operation: «removal of the pelvic retroperitoneal tumor with resection of the external iliac vein' segment and pelvic lymph node dissection.» Histological examination: leiomyosarcoma, G2 FNCLCC.

Results: control MSCT - data on the recurrence of the iliac vein tumor and metastatic lesion of organs of chest, abdominal and pelvic cavity were not obtained.

Conclusions: a complex of diagnostic methods allows you to properly diagnose. And among these methods, multiphase computed tomography is one of the best imaging method, which shows not only the localization of the tumor, but also helps in staging, excluding or confirming vein thrombosis, solving the issue of resectability of the tumor and identifying distant metastasis. 

 

References

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Abstract:

Aim: was to estimate the diagnostic value of MRI (qualitative and tumor size analysis) in the evaluation of preoperative chemotherapy in patients with soft tissue sarcomas on different stages of examination.

Material and methods: we analyzed data of 74 patients with soft tissue sarcomas. All patients underwent MRI. Patients were examined before, in the middle and at the end of the course of the preoperative chemotherapy

Results: the sensitivity (predilection of Grade III-IV pathologic response) of qualitative MRI signs in the middle of the neoadjuvant chemotherapy (after 2-3 cycles) was 73%, the specificity (predilection of Grade I-II pathologic response) was 88%; 69% and 100% for maximum tumor size evaluation, correspondingly At the end of the preoperative treatment, values of the sensitivity and specificity of qualitative MRI signs decreased to 50% and 78%, respectively, the sensitivity of maximum tumor size estimation decreased to 31%, while specificity remained the same -100%.

Conclusion: MRI with qualitative and tumor size analysis is an informative method in assessment of preoperative chemotherapy of soft tissue sarcomas.

 

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