Question:

Regarding retroperitoneal leiomyosarcoma, which of the following answer choices are true?
1. CT is the primary imaging modality.
2. The imaging appearance of leiomyosarcoma is very specific.
3. At the time of diagnosis the primary tumor masses are usually quite large.
4. Calcification is a characteristic feature.
5. Leiomyosarcomas may present as an intraluminal mass lesion in the IVC.





Answer:

The correct answers for the question "Regarding retroperitoneal leiomyosarcoma, which of the following answer choices are true?" are:

1. CT is the primary imaging modality.

3. At the time of diagnosis the primary tumor masses are usually quite large.

5. Leiomyosarcomas may present as an intraluminal mass lesion in the IVC.



Explanation
1. CT is the primary imaging modality for the assessment of retroperitoneal leiomyosarcomas as well as for the evaluation of metastatic disease.

2. The imaging appearance of leiomyosarcoma is non-specific and histopathology with immunohistochemistry is essential for the correct diagnosis.

3. Most retroperitoneal leiomyosarcomas grow silently and by the time of diagnosis the primary tumor masses are usually quite large in size with extensive necrotic or cystic change.

4. Calcification is rare in these tumors.

5. Rarely, leiomyosarcomas may arise from the IVC itself, with predominantly intraluminal growth.



From the manuscript:
Local recurrence and multi-organ metastasis of primary retroperitoneal leiomyosarcoma in unusual locations after surgical resection
Radiology Case. 2011 June; 5(6):1-8


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From the manuscript

Local recurrence and multi-organ metastasis of primary retroperitoneal leiomyosarcoma in unusual locations after surgical resection

Free full text article: Local recurrence and multi-organ metastasis of primary retroperitoneal leiomyosarcoma in unusual locations after surgical resection

Abstract
We report a case of retroperitoneal leiomyosarcoma in a 52-year-old woman, who developed local recurrence, pulmonary, hepatic, peritoneal, pancreatic, subcutaneous and intramuscular metastases two years after surgical resection of the primary tumor. Metastasis to the pancreas, subcutaneous or muscular tissue is very rare; however, presence of a lesion in these locations in a known case of leiomyosarcoma might indicate a metastatic tumor deposit.






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