Leiomyosarcoma of the great saphenous vein (vena saphena magna) with granular cell change. Report of a superficial neoplasm

Abstract

The great saphenous vein (GSV) corresponds to the main superficial large caliber vessel affected by leiomyosarcoma (LMS). Given its superficial location and because signs of vascular origin may not be clinically apparent, LMS of the GSV may be misinterpreted clinically as superficial non-vascular soft tissue mass. Herein we report a case on the distal portion of the right GSV of a 57year-old man. The histopathological recognition of a large caliber vein-associated LMS (with granular cell change) in an incisional biopsy specimen was crucial to guide radiological evaluation and confirmation of a superficial vascular LMS before surgical treatment. Recognizing this entity in small biopsies is important as its surgical treatment and prognosis differ substantially from non-vascular superficial soft tissue (i.e. subcutaneous and dermal) LMSs. In addition, because vascular LMSs can involve long vessel segments, underestimation of extent of disease is a risk. To the best of our knowledge, granular cell change has not been documented in LMS of the GSV.