Leiomyosarcoma of the Inferior Vena Cava with Cardiac Extension; A Rare Cause of Acute Liver Failure

Leiomyosarcoma of vascular origin is a rare malignant tumor. Inferior vena cava (IVC) is the most common site of vascular leiomyosarcomas. Leiomyosarcoma of IVC is predominantly seen in middle-aged women presenting with non-specific symptoms and clinical findings. Herein, we report a case of leiomyosarcoma of IVC in a 44-year-old woman presented with progressive abdominal discomfort and postprandial vomiting. Laboratory results were in favor of acute liver injury. Imagings revealed a retroperitoneal mass and enhancement in almost the total course of inferior vena cava with extension into both renal veins and right atrium. Histopathological examination showed a malignant spindle cell tumor and immunohistochemistry confirmed smooth muscle origin of the tumor.