A Multi-Center Randomized Controlled Trial to Evaluate the Efficacy of Ultrasound-Guided Foam Sclerotherapy in Venous Leg Ulcers

Objectives: Vascular leiomyosarcoma is rare and has a poor prognosis.There are few reported cases of primary vascular leiomyosarcoma in the common iliac vein.We report a case of primary leiomyosarcoma in the left common iliac vein and provide a literature review.Methods: The patient was a 73-year-old woman who noticed a mass on her head and underwent an excision biopsy at our dermatology department.Pathological examination revealed atypical cells, and the tumor was SMA(+), desmin(+), CD34(-), and S-100(-).The tumor was diagnosed as leiomyosarcoma.Contrast computed tomography, magnetic resonance imaging, and positron emission tomography were performed for a systemic examination, and a tumor measuring 60 32 mm was revealed in the left common iliac vein, which was considered to the primary lesion.There was no lung, liver, or lymph node metastasis.The left common iliac vein was occluded, but there was no lower limb edema or pulmonary embolism.The tumor was resected through surgery, with the left common iliac vein also resected.Although removal was difficult due to severe adhesion to the surrounding tissue, the white elastic tumor was completely resected.The postoperative course was uneventful, and the patient was discharged.Results: The left lower limb edema appeared after surgery, but it improved with compression stockings for about a month.Six months have passed since the operation, and the patient has survived without any recurrence or complication.Pathology showed high malignancy with Ki67 (30%), but the primary tumor had been resected, and the proximal lymph nodes were negative.Since there was no recurrence, discussions were held with some departments, and it was decided that postoperative radiation or chemotherapy would not be performed, and the patient would be strict follow-up.Conclusions: Radiation therapy and chemotherapy are performed preand post-operation; these have only been reported in case reports.Surgical resection is considered the most effective treatment.According to previous reports, by the time of diagnosis, the tumor has often grown and metastasized to other organs, and it makes it inoperable.In this case, two tumors in different locations were completely resected.Although no postoperative chemotherapy or radiation therapy was performed, the patient has been free of recurrence.This is a rare case; we will report it with some consideration.