{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:12:35Z","timestamp":1788415955762,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leiomyosarcoma of the inferior vena cava is a rare and malignant soft tissue tumor. Diagnosis is often delayed due to non-specific symptoms. Imaging is crucial, yet preoperative differentiation remains challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 59-year-old woman presented with a two-year history of right upper quadrant pain. Initial ultrasound revealed a large, well-defined, hypoechoic hepatic mass (10.6 \u00d7 7.8\u00a0cm) with heterogeneous echotexture featuring multiple strip-like hyperechoic regions and irregular anechoic areas. Contrast-enhanced ultrasound showed a malignant enhancement pattern. Chest CT indicated pulmonary metastases. Initial ultrasound diagnosis was primary hepatic leiomyosarcoma. Ultrasound-guided biopsy confirmed leiomyosarcoma. Subsequent targeted comprehensive imaging re-evaluation, including retrospective review of ultrasound cine loops and MRI sequences, demonstrated tumor continuity with the IVC lumen, leading to the final diagnosis of primary inferior vena cava leiomyosarcoma with hepatic extension and pulmonary metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case demonstrates that targeted ultrasound re-evaluation is valuable for clarifying the tumor\u2013IVC relationship. The sonographic finding of multiple strip-like hyperechoic regions may be a characteristic feature of inferior vena cava leiomyosarcoma. We propose that leveraging imaging similarities between smooth muscle tumors across different anatomical sites (e.g., uterus, peripheral veins) can foster a cross-organ diagnostic mindset. Furthermore, exploring cross-organ, cross-modality transfer learning models could address data scarcity and enhance diagnostic capabilities for rare entities like inferior vena cava leiomyosarcoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1830666","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:14:55Z","timestamp":1788412495000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Primary inferior vena cava leiomyosarcoma with hepatic metastases initially misinterpreted as primary hepatic leiomyosarcoma \u2013 ultrasonographic features and diagnostic insights"],"prefix":"10.3389","volume":"16","author":[{"given":"Yimei","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Ultrasound, The Second Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasha","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Cong","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq039","article-title":"Clinical outcome of leiomyosarcomas of vascular origin: comparison with leiomyosarcomas of other origin","volume":"21","author":"Italiano","year":"2010","journal-title":"Ann Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000002701","article-title":"Leiomyosarcoma of the inferior vena cava: case report","volume":"87","author":"Hafhaf","year":"2025","journal-title":"Ann Med Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/00031348251333096","article-title":"Primary IVC leiomyosarcoma: a case series and review of the literature","volume":"91","author":"Bartholomew","year":"2025","journal-title":"Am Surg"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1442674","article-title":"Leiomyosarcomas of the inferior vena cava: diagnostic features on contrast-enhanced CT, ultrasonography and MRI","volume":"15","author":"Xu","year":"2025","journal-title":"Front Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2010.08.004","article-title":"Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging","volume":"66","author":"Ganeshalingam","year":"2011","journal-title":"Clin Radiol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2014.10.007","article-title":"Outcomes after resection of leiomyosarcomas of the inferior vena cava: a pooled data analysis of 377 cases","volume":"24","author":"Wachtel","year":"2015","journal-title":"Surg Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.10.011","article-title":"Primary leiomyosarcoma of the inferior vena cava: a 2-institution analysis of outcomes","volume":"151","author":"Mann","year":"2012","journal-title":"Surgery"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018160821","article-title":"Case 257: Leiomyosarcoma of the inferior vena cava","volume":"288","author":"Bednarova","year":"2018","journal-title":"Radiology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S1290-0176(04)37425-9","article-title":"L\u00e9iomyoscarcomes de la veine cave inf\u00e9rieure","volume":"8","author":"Soury","year":"2004","journal-title":"EMC - Ang\u00e9iol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.5582\/irdr.2024.01037","article-title":"Inferior vena cava leiomyosarcoma mimicking an exophytic intrahepatic cholangiocarcinoma","volume":"13","author":"Qian","year":"2024","journal-title":"Intractable Rare Dis Res"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.7476","article-title":"Can CT features differentiate between inferior vena cava leiomyosarcomas and primary retroperitoneal masses","volume":"200","author":"Webb","year":"2013","journal-title":"Am J Roentgenol"},{"key":"B12","first-page":"491","article-title":"Origin of abdominal tumors: useful findings and signs on tomographic imaging","volume":"201","author":"Minami","year":"1996","journal-title":"(abstr) Radiology"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.36570\/jduhs.2019.2.596","article-title":"Primary leiomyosarcoma of the inferior vena cava: rare case report","volume":"13","author":"Lalwani","year":"2019","journal-title":"J Dow Univ Health Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.15388\/Amed.2022.29.2.12","article-title":"Incidentally diagnosed extraluminal leiomyosarcoma of infrarenal inferior vena cava: a case report and literature review from a radiologist\u2019s perspective","volume":"29","author":"A","year":"2022","journal-title":"Acta Med Litu"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.22710","article-title":"Preoperative intravascular ultrasonographic evaluation of leiomyosarcoma of the inferior vena cava: a case report","volume":"47","author":"Chiba","year":"2019","journal-title":"J Clin Ultrasound"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s005950200185","article-title":"Surgical treatment of retroperitoneal leiomyosarcoma invading the inferior vena cava: report of three cases","volume":"32","author":"Shindo","year":"2002","journal-title":"Surg Today"},{"key":"B17","doi-asserted-by":"publisher","first-page":"30","DOI":"10.3941\/jrcr.v13i5.3641","article-title":"Leiomyosarcoma of the inferior vena cava with hepatic and pulmonary metastases: case report","volume":"13","author":"Sephien","year":"2019","journal-title":"J Radiol Case Rep"},{"key":"B18","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1002\/jso.24256","article-title":"Long\u2010term outcomes in treatment of retroperitoneal sarcomas: a 15 year single\u2010institution evaluation of prognostic features","volume":"114","author":"Abdelfatah","year":"2016","journal-title":"J Surg Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1148\/rg.352130105","article-title":"Leiomyosarcoma of the inferior vena cava: AIRP best cases in radiologic-pathologic correlation","volume":"35","author":"Monteagudo Cortecero","year":"2015","journal-title":"RadioGraphics"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjaa479","article-title":"Leiomyosarcoma of the inferior vena cava: a case report","volume":"2020","author":"Graves","year":"2020","journal-title":"J Surg Case Rep"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.04.021","article-title":"Primary leiomyosarcoma of the great saphenous vein: case report and review of the literature","volume":"38","author":"Cangiano","year":"2017","journal-title":"Ann Vasc Surg"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008581","article-title":"Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis: a case report","volume":"96","author":"Zhang","year":"2017","journal-title":"Med (Baltimore)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s002610000079","article-title":"Intrahepatic peripheral cholangiocarcinoma: CT evaluation","volume":"25","author":"Valls","year":"2000","journal-title":"Abdom Imaging"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.129636","article-title":"Pararenal vena cava leiomyosarcoma versus leiomyomatosis: difficult diagnosis","volume":"36","author":"Armstrong","year":"2002","journal-title":"J Vasc Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.5114\/pm.2017.72754","article-title":"Ultrasonography of uterine leiomyomas","volume":"16","author":"Wo\u017aniak","year":"2017","journal-title":"Menopausal Rev"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2019.07.007","article-title":"How to differentiate uterine leiomyosarcoma from leiomyoma with imaging","volume":"100","author":"Sun","year":"2019","journal-title":"Diagn Interv Imaging"},{"key":"B27","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1002\/uog.16286","article-title":"OP14.03: Ultrasound features of uterine sarcomas","volume":"48","author":"Ludovisi","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2013.ed20","article-title":"International rare cancers initiative (IRCI)","volume":"7","author":"Keat","year":"2013","journal-title":"Ecancermedicalscience"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2020.3038909","article-title":"Cross-organ, cross-modality transfer learning: feasibility study for segmentation and classification","volume":"8","author":"Lee","year":"2020","journal-title":"IEEE Access"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1830666\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:14:59Z","timestamp":1788412499000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1830666\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":29,"alternative-id":["10.3389\/fonc.2026.1830666"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1830666","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1830666"}}