EURORAD ESR

Case 9921

A strange cause of portal hypertension: leiomyosarcoma of the portal vein.

Author(s)
Castrillo Maortua A, Aguirregoicoa Olabarrieta I, Hormaza Aguirre N, Lázaro Serrano M, Peña Sarnago JM

Hospital Universitario de Cruces.
Plaza de Cruces s/n. 48903. Vizcaya. Spain.
e-mail: anacastrillomaortua@gmail.com
 
Patient
female, 44 year(s)
 
 
  • Figure 1
    Arterial phase
     

    A big mass with a lot of vessels enhancing on the arterial phase.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    Vascularization depends on the gastroduodenal artery and branches of the superior mesenteric and splenic arteries. Early enhancement of the intrahepatic portal branches suggesting arteriovenous fistulas.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    Hypertrophied gastroduodenal artery (VR).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
  • Figure 2
    Venous phase
     

    A mass located on the portomesenteric axis, with a maximum diameter of 11.5 cm.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    VR correlation.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
  • Figure 3
    Cavernous transformation

    Venous collaterals and VR correlation.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
  • Figure 4
    Tumour thrombosis

    Thrombus in the superior mesenteric vein and oblique MPR showing the extension of the mass to the hepatic hilum.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
  • Figure 5
    A normal pancreatic gland
     

    The Wirsung duct was not dilated and the pancreas seemed undamaged.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    The pancreatic gland was displaced anteriorly.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
A big mass with a lot of vessels enhancing on the arterial phase.
 
Vascularization depends on the gastroduodenal artery and branches of the superior mesenteric and splenic arteries. Early enhancement of the intrahepatic portal branches suggesting arteriovenous fistulas.
 
Hypertrophied gastroduodenal artery (VR).
 
A mass located on the portomesenteric axis, with a maximum diameter of 11.5 cm.
 
VR correlation.
 
Venous collaterals and VR correlation.
 
Thrombus in the superior mesenteric vein and oblique MPR showing the extension of the mass to the hepatic hilum.
 
The Wirsung duct was not dilated and the pancreas seemed undamaged.
 
The pancreatic gland was displaced anteriorly.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version