[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-446445-105":59,"doc-detail-446445-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","vascular-leiomyosarcoma-masquerading-as-chronic-deep-venous-thrombosis-abstract","Vascular Leiomyosarcoma Masquerading as Chronic Deep Venous Thrombosis - Abstract","","Vascular leiomyosarcoma presenting as chronic deep venous thrombosis is illustrated by a 78-year-old man with prior DVT on apixaban. Bilateral leg pain and dyspnea led to CTA excluding pulmonary embolism while bilateral pulmonary nodules were discovered. Imaging and biopsy confirmed an intraluminal, high-grade spindle cell neoplasm positive for SMSA and desmin, consistent with leiomyosarcoma. Multimodal assessment and biopsy were essential for diagnosing this rare intravascular malignancy with metastatic potential.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/vascular-leiomyosarcoma-masquerading-as-chronic-deep-venous-thrombosis-abstract/446445/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/vascular-leiomyosarcoma-masquerading-as-chronic-deep-venous-thrombosis-abstract/446445.png","ImageObject",300,407,{"name":92,"@type":93},"Pentious","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why did the clinicians initially suspect deep venous thrombosis?","Question",{"text":112,"@type":113},"The patient had a history of DVT on apixaban and presented with bilateral leg pain. Duplex ultrasound diagnosed acute DVT without considering tumor as a differential diagnosis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What key imaging findings supported the diagnosis of vascular leiomyosarcoma?",{"text":117,"@type":113},"Chest CTA ruled out pulmonary embolism but showed bilateral pulmonary nodules. 18F-FDG PET and duplex ultrasound demonstrated intensely FDG-avid intraluminal masses in the right femoral and popliteal veins, and MRI confirmed lesions with peripheral enhancement.",{"name":119,"@type":110,"acceptedAnswer":120},"How was leiomyosarcoma confirmed definitively?",{"text":121,"@type":113},"Biopsy of a femoral vein mass revealed a high-grade spindle cell neoplasm with positivity for SMSA and desmin, consistent with leiomyosarcoma.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446445,1790819122,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},1374404730887,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Vascular Leiomyosarcoma Masquerading as Chronic Deep  \nVenous Thrombosis  \nIsabella Phillips, BS,* Jason Chen, BS,* Mohammed Milhem, MBBS,† Paul DiCamillo, MD, PhD,‡ and Janet Pollard, MD‡  \nAbstract: A 78-year-old man with a history of DVT on apixaban presented with bilateral leg pain and dyspnea. Chest CTA ruled out pulmonary embolism but revealed bilateral pulmonary nodules. Biopsy identified a spindle cell neoplasm. 18F-FDG PET and duplex ultrasound imaging revealed intensely FDG-avid, intraluminal masses in the right femoral and popliteal veins. MRI confirmed lesions with peripheral enhancement. Biopsy of one of the femoral vein masses showed a high-grade spindle cell neoplasm positive for SMSA and desmin, consistent with leiomyosarcoma. This rare vascular tumor mimicked DVT, highlighting the importance of multimodal imaging and biopsy in diagnosing intravascular malignancies with metastatic potential.  \nKey Words: leiomyosarcoma, intravascular, metastasis (Clin Nucl Med 2026;51:132–133)  \nReceived for publication July 10, 2025; accepted October 15, 2025 .  \nFrom the *Department of Internal Medicine, University of Iowa Carver College of Medicine; †Department of Internal Medicine, Holden Comprehensive Cancer Center, University of Iowa Health Care; and ‡Department of Radiology, University of Iowa Health Care, Iowa City, IA.  \nI.P. and J.C. contributed equally to this work.  \nConflicts of interest and sources of funding: none declared.  \nCorrespondence to: Mohammed Milhem, MBBS, University of IowaHolden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, IA, [52242. E-mail: mohammed-milhem@uiowa.edu](52242. E-mail: mohammed-milhem@uiowa.edu).  \nCopyright © 2025 The Author(s) . Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4 .0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nDOI: 10.1097/RLU.0000000000006240  \nREFERENCES  \n1. Bothara SS, Patil R, Parihar P, et al. Decoding femoral vein leiomyosarcoma: a rare vascular malignancy revealed through imaging. Cureus. 2024;16:e64370 .  \n2. Paraskevas N, Castier Y, Dauge MC, et al. A rare case of leiomyosarcoma arising from a femoral vein tributary: a case report. Vasc Med. 2009;14:149–151.  \n3. Abed R, Abudu A, Grimer RJ, et al. Leiomyosarcomas of vascular origin in the extremity. Sarcoma. 2009;2009:385164 .  \n4. Pizzini AM, Tripolino C. Femoral vein leiomyosarcoma mimicking thrombosis. Ann Vasc Surg. 2021;74:520 .e19–e22 .  \n5. Roland CL, Boland GM, Demicco EG, et al. Clinical observations and molecular variables of primary vascular leiomyosarcoma. JAMA Surg. 2016;151:347–354.  \n6. Xu Y, Xie W, Shang D. Primary leiomyosarcoma is a rare cause of femoral triangle mass: a case report. Vascular. 2021;29: 468–471.  \n7. Yfadopoulos D, Nikolopoulos D, Novi E, et al. Primary superficial femoral vein leiomyosarcoma: report of a case. Surg Today. 2011;41:1649–1654.  \n8. Gow CH, Liaw YS, Chang YL, et al. Primary vascular leiomyosarcoma of the femoral vein leading to metastases of scalp and lungs. Clin Oncol (R Coll Radiol) . 2005;17:201 .  \n9. Zhang M, Yan F, Huang B, et al. Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis: a case report. Medicine (Baltimore) . 2017;96:e8581 .  \n10. Kannan S, Chong HH, Chew B, et al. Leiomyosarcoma in the extremities and trunk wall: systematic review and meta-analysis of the oncological outcomes. World J Surg Oncol. 2022;20:124 .  \n11. Rondina MT, Lam UT, Pendleton RC, et al. (18)F-FDG PET in the evaluation of acuity of deep vein thrombosis. Clin Nucl Med. 2012;37:1139–1145.  \n12. Sharma P, Kumar R, Jeph S, et al. 18F-FDG PET-CT in the diagnosis of tumor thrombus: can it be differentiated from benign thrombus? Nucl Med Commun. 2011;32:782–788.  \n13. Kikuchi M, Yamamoto E, Shiomi Y, et al. Case report: in","cbCailZQYY27Mcai","https://ap.wps.com/l/cbCailZQYY27Mcai","pdf",398457,"English","# Abstract\n## Case presentation\n## Imaging findings\n## Biopsy and diagnosis\n## Clinical significance","[{\"question\":\"Why did the clinicians initially suspect deep venous thrombosis?\",\"answer\":\"The patient had a history of DVT on apixaban and presented with bilateral leg pain. Duplex ultrasound diagnosed acute DVT without considering tumor as a differential diagnosis.\"},{\"question\":\"What key imaging findings supported the diagnosis of vascular leiomyosarcoma?\",\"answer\":\"Chest CTA ruled out pulmonary embolism but showed bilateral pulmonary nodules. 18F-FDG PET and duplex ultrasound demonstrated intensely FDG-avid intraluminal masses in the right femoral and popliteal veins, and MRI confirmed lesions with peripheral enhancement.\"},{\"question\":\"How was leiomyosarcoma confirmed definitively?\",\"answer\":\"Biopsy of a femoral vein mass revealed a high-grade spindle cell neoplasm with positivity for SMSA and desmin, consistent with leiomyosarcoma.\"}]","Vascular Leiomyosarcoma Masquerading as Chronic Deep Venous Thrombosis - Abstract | PDF",1790715440]