Primary Leiomyosarcoma of Suprahepatic Inferior Vena Cava with Metastases.

A 67-year-old female presented with shortness of breath, weight loss, abdomen, and back pain for 2 months. Ultrasound of the abdomen revealed multiple focal liver lesions. 18F-Fluorodeoxyglucose whole-body positron emission tomography/computed tomography revealed a hypermetabolic lesion in the suprahepatic inferior vena cava extending into the right atrium. Multiple hypermetabolic lesions were seen in liver, bones, and abdominal lymph nodes, suggestive of metastases. Histopathology and immunohistochemistry of the lesions revealed it to be metastatic leiomyosarcoma.