<b>Medical Journal Article Annotated Citations

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Eur J Surg Oncol 1991 Apr;17(2):125-34 
Leiomyosarcoma of large and small veins: clinical findings and results of treatment in six patients. 
van Gulik TM, Taat CW, Slors JF, Bras J, Blank LE, Bakker PJ, Kromhout JG, Brummelkamp WH. Department of Surgery, University of Amsterdam, The Netherlands. 

Vascular leiomyosarcomas are rare malignant tumours originating from the media of the vessel wall. Six patients (five women and one man, aged 44-66 years) have been treated for a vascular leiomyosarcoma located in the inferior vena cava (three patients), the suprarenal, the external iliac and an antecubital vein. In four patients, the tumour was large and extended beyond the vessel wall giving rise to a retroperitoneal mass. In two patients the tumour was confined to the inner wall of respectively a large and small vein, occluding the lumen; the former was in the inferior vena cava and the latter in an antecubital vein. Block resection was performed in all patients. The tumours showed mitotic indices ranging from 6-32 mitoses/10 high power fields. The five patients with retroperitoneal tumours received additional radiotherapy varying from 50.00-70.00 Gy, on the basis of either macroscopic residual tumour or indefinite radicality. One of these five patients developed distant metastases within 2.5 years without local recurrence, the other four had no evidence of recurrence at follow-up, 3-7 years (mean 4.2 years) after surgery. The results illustrate the role of adjuvant radiotherapy in the control of local recurrence, when resection in this type of tumour proves to be either non-radical or totally radical. 
&&url PMID: 2015919 


Cancer 1986 Apr 1;57(7):1395-400
<b>Intramural venous leiomyosarcomas.</b> 
Leu HJ, Makek M. 

Five cases of intramural venous leiomyosarcomas are described. Only one was localized in the inferior vena cava, the classic site; the other four cases were situated in smaller veins, namely, the short and long saphenous veins, the external jugular vein, and a superficial vein at the back of the hand. Light and, in two cases, electron microscopy, as well as immunohistochemical examinations for factor VIII, helped to establish the diagnosis. The fate of these cases indicates that size and localization are the main determining factors of outcome, whereas the level of mitotic activity is informative only if it is high.<b> Small tumors in superficial veins that are detected early may have an excellent prognosis, even after limited removal of the tumor.</b> 
&&url PMID: 3081244 
