Pleomorphic Liposarcoma of the Inferior Vena Cava: AIRP Best Cases in Radiologic-Pathologic Correlation.
Radiographics. 2015 Jan-Feb;35(1):269-74. doi: 10.1148/rg.351140198.
Senapati GM1, Sheiman RG, Almashat S, Goldsmith JD.
A 27-year-old man with a history of asthma presented to the emergency department because of a sudden onset of left lower extremity swelling extending from the midthigh to the calf. Duplex ultrasonography (US) helped confirm extensive left lower extremity deep venous thrombosis. Laboratory evaluations for hypercoagulability, including anticardiolipin antibodies, β2-glycoprotein, factor V Leiden, protein C and S mutation, prothrombin gene mutation, and lupus anticoagulant, were negative. The patient was started on anticoagulation therapy, and his lower extremity symptoms improved. Three months after the initial episode, the patient experienced intermittent abdominal and right-flank pain that partially improved with use of simethicone but did not entirely resolve. He continued on therapeutic doses of warfarin sodium for 5 months after the initial presentation but then presented to an outside hospital with chest pain and shortness of breath. Computed tomographic (CT) angiography showed pulmonary embolism despite the maintenance of a therapeutic international normalized ratio. Evaluation for an occult malignancy was begun at that time.