Bilateral Lower Limb Swelling

60-year-old patient presented with complaint of bilateral lower limb swelling.

Figure 1. Short echo time image shows mass in IVC as isointense and thrombus in IVC as hyperintense.

Figure 2. Short echo time image shows mass in IVC as isointense and thrombus in IVC as hyperintense.

Figure 3. Contrast image shows nonenhancing thrombus in iliac veins.

Figure 4. Contrast image shows nonenhancing thrombus in iliac veins.

Figure 5. T2W image shows mass in IVC.

Figure 6. T2W image shows mass in IVC.

Figure 7. T1W image shows mass in IVC.

Figure 8. Dual fast field echo T1/short T2 shows thrombus in IVC.

Diagnosis: Leiomyosarcoma of the inferior vena cava

Leiomyosarcoma of IVC is a rare entity with fewer than 300 cases in reported in literature.

Leimyosarcoma can cause IVC obstruction with lower limb swelling or hepatic vein obstruction (Budd-Chiari syndrome).