Could Ovarian Veins Be the Origin of Most Retroperitoneal Leiomyosarcomas?

Abstract

I have read with interest the case report of Iwagami et al. “Internal High Echoes Can Suggest the Possible Resection of Ovarian Vein Leiomyosarcoma: A Case Report” [1], which describes a rare patient with leiomyosarcoma originating from the right gonadal vein. The authors have clearly defined the radiological continuity of the tumor with the gonadal vein and revealed its relationship with adjacent structures such as the vena cava and duodenum.

The authors have successfully revealed that the gonadal vein is the source of a retroperitoneal leiomyosarcoma, I congratulate them. The origin of the majority of retroperitoneal leiomyosarcomas cannot be determined. But there are some indirect findings that suggest that a significant part of it may actually be originated from gonadal veins.

Awareness is needed for future studies to evaluate gonadal veins as a potential source of retroperitoneal leiomyosarcomas of uncertain origin. For this reason, I believe that retroperitoneal leiomyosarcomas, whose origin has been definitively established, although rare, are important, as in this case.

The fact that the gonadal vein has a possible origin in retroperitoneal leiomyosarcomas could potentially change treatment strategies. Immunohistochemical profile examinations in pathological examinations can be a guide in this regard.

The author declares no conflicts of interest.

This article is linked to Iwagami et al. paper. To view this article, visit https://doi.org/10.1002/iju5.70025.