Primary leiomyosarcoma of the innominate vein

Primary Leiomyosarcoma of the Innominate Vein Giulio Illuminati, MD, Fabio Miraldi, MD, Giuseppe Mazzesi, MD, Antonio D’urso, MD, Gianluca Ceccanei, MD, and Marcello Bezzi, MD, Rome, Italy Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread. Primary venous leiomyosarcoma is rare and affects most commonly the inferior vena cava, whereas, sporadically, other primary venous localizations have been reported, including ovarian, iliac, and greater saphenous veins.1 It is usually considered a lethal disease;1 nevertheless, long-term survival after curative surgery can be achieved.2 The rare observation of a primary leiomyosarcoma of the left innominateeinternal jugular vein, without distant spread at the time of diagnosis, treated with radical surgical resection, is reported herein.