Imaging features and metastatic pattern of non-IVC retroperitoneal leiomyosarcomas: Are they different from IVC leiomyosarcomas?

Christine L. Cooley, Jyothi P. Jagannathan, Vikram Kurra, Sree Harsha Tirumani, Sachin S. Saboo, Nikhil H. Ramaiya, Atul B. Shinagare

Research output: Contribution to journalReview article

11 Scopus citations


Purpose: The purposes of this study were to describe the imaging features and metastatic pattern of non-inferior vena cava (IVC) retroperitoneal leiomyosarcomas (non-IVC LMS) and to compare them with those of IVC leiomyosarcomas (IVC LMS) to assess any differences between the 2 groups.

Materials and Methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, all 56 patientswith pathologically confirmed primary retroperitoneal leiomyosarcoma (34 non-IVC LMS and 22 IVC LMS) seen at our tertiary cancer center during a 10-year period were included. All available imaging of primary tumor (18 non-IVC LMS and 19 IVC LMS) and follow-up imaging studies (on all 56 patients) were reviewed in consensus by 2 fellowship-trained oncoradiologists. Imaging features and metastatic spread of non-IVC LMS were described and compared with those of IVC LMS. Continuous variables were compared using the Student t test, binary variables with the Fisher exact test, and survival using the logrank test.

Results: Non-inferior vena cava retroperitoneal leiomyosarcomas had a mean size of 11.3 cm (range, 3.7-27 cm) and most commonly occurred in the perirenal space (16/18). Primary tumors were hyperattenuating to muscle (11/18) and showed heterogeneous enhancement (17/18). Lungs (22/34), peritoneum (18/34), and liver (18/34) were the most common metastatic sites. There was no significant difference between the imaging features and metastatic pattern of non-IVC and IVC LMS. Although non-IVC LMS presented at a more advanced stage (P < 0.002), there was statistically non-significant trend toward better median survival of non- IVC LMS (P = 0.07).

Conclusions: Non-inferior vena cava retroperitoneal leiomyosarcomas are large heterogeneous tumors arising in the perirenal space and frequently metastasize to lungs, peritoneum, and liver. From a radiologist's perspective, non-IVC LMS behave similar to IVC-LMS.

Original languageEnglish (US)
Pages (from-to)687-692
Number of pages6
JournalJournal of computer assisted tomography
Issue number5
StatePublished - Jan 1 2014



  • Imaging features
  • Inferior vena cava
  • Leiomyosarcoma
  • Metastatic pattern
  • Retroperitoneal

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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