Radiological, surgical, and pathological findings of leiomyosarcoma of the inferior vena cava. (A) Contrast-enhanced CT scan revealed the leiomyosarcoma of the inferior vena cava (arrow) in case 1. (B) The resection of IVCL masses removed by the surgery in case 1. (C) Pathological view of the leiomyosarcoma: Moderately differentiated leiomyosarcoma with a fascicular growth pattern in case 1 (arrows). HE stain (×200). (D) The positive immunohistochemical staining for Caldesmon (×200) in case 1. (E) Immunohistochemical staining reveals the smooth muscle actin (SMA) expression in case 1; (×200). (F) The leiomyosarcoma of the inferior vena cava invading the right renal and left renal vein ostium in case 2. (G) Surgical view of the reconstruction of the bilateral renal veins with vascular prostheses; draining into proximal residual inferior vena cava in case 1.