CTICasesRetropleural Leiomyosarcoma
Imaging findings
CT chest shows a massive, aggressive, retropleural and para-aortic soft tissue mass in the lower right hemithorax, contiguous with the aorta and vertebral bodies, showing intense FDG avidity on PET-CT. Transesophageal biopsy confirmed a high-grade leiomyosarcoma.
Key takeaways
Leiomyosarcomas of the mediastinum or retropleural space are rare, highly aggressive malignant smooth muscle tumors. They typically present as large, lobulated masses with shaggy necrosis that can invade surrounding vascular structures like the aorta, esophagus, or azygos system, requiring wide surgical excision.
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