PMC6159251_01
Multiplanar contrast-enhanced multidetector CT images reveal a mass in the portal vein (*). Axial CT image (a) shows numerous collaterals around the heterogeneously enhancing mass (*). There is a rim of contrast around the mass (white arrowheads) indicating that the mass has an intraluminal origin rather than tumour invasion from adjacent structures. Corresponding coronal CT image (b) shows a sharp interface with the appearance of a "beak" (white arrowheads) between the opacified main portal vein and the mass (*).
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On the portal venous phase, numerous collaterals were seen surrounding the mass with a sharp interface between the mass and opacified portion of the main portal vein at the porta hepatis giving the appearance of a "beak" (Figure 1).
Microscopic findings of the resected specimen showing the leiomyosarcoma arising from within the portal vein and confined in the lumen (hematoxylin-eosin, 200x magnification).
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The final histological diagnosis was of a primary LMS of the portal vein (Figure 2).