Leiomyosarcoma of the cephalic vein: case report and review of the literature.

Vascular leiomyosarcoma is extremely rare and represents < 2% of all leiomyosarcomas. The frequency of occurrence of leiomyosarcomas in veins is five times more than in arteries, with approximately half of them occurring in the inferior vena cava. Although leiomyosarcomas originating from large arteries or veins have been widely reported, similar tumors of peripheral vessels of upper extremities are extremely rare. To our knowledge, leiomyosarcomas of the cephalic vein over the wrist area have not been previously documented. We report a case of leiomyosarcoma of the cephalic vein in a 63-year-old man who presented with right hand and forearm swelling and tenderness for more than 1 year. Grossly, a solitary, elongated, white, and firm intraluminal growth tumor was infiltrative along the vessel wall with focal nodular formation and filled the lumen of cephalic vein, measuring 11 cm in length. Histological study revealed an intermediate-grade leiomyosarcoma of vascular origin.