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Leiomyosarcoma of the inferior vena cava is a rare tumor that is usually fatal. The tumor may grow very slowly or occasionally very rapidly, shows extensive local invasion, and metastasizes more frequently than previously believed. Complete surgical resection remains the only potential curative therapeutic option. The aim of this study was to report the clinical experience in the management of a patient with leiomyosarcoma. A 65-year-old woman with a history of vague abdominal pain and leg swelling underwent computed tomography which demonstrated an occlusion of the inferior vena cava. The patient received a complete excision of the tumor without reconstruction and histological analysis confirmed the diagnosis of leiomyosarcoma type 1. At 3 years, the patient is still doing well with minimal leg edema and a contrast-enhanced CT demonstrates no evidence of recurrence locally or in distant sites. Leiomyosarcoma is a rare and aggressive tumor that presents with non-specific symptoms. Computerized tomography with 3-D reconstruction is a useful tool to define the presence and entity of the collateral circulation and therefore to decide on the surgical strategy. Resection probably offers the best opportunity for long-term survival.

In this paper, we describe two cases of anomalous origin of the left coronary artery and two cases of aneurysm on the left coronary artery. Detailed three-dimensional images were acquired by the multislice computed tomography (MSCT) SOMATOM Sensation Cardiac 64 during clinical studies of cardiac diseases.

In this article, we describe two cases of anomalous connection of the left coronary artery. The first case is an infant of 4 years with an anomalous origin of the left anterior descending (LAD) artery and the diagonal branches and a circumflex artery which originated from the pulmonary artery. The second case is an adult of 50 years with the coronary artery originating from the pulmonary artery. Anomalous origin of the left coronary artery from the pulmonary artery is an uncommon congenital cardiac anomaly with an incidence of 0.25% among all congenital heart defects (Parale and Pawar [2006], J Assoc Physicians India 54:397-399). The originality of this communication consists in the use of a multislice CT scanner as a support for the angiography. The result is an original image with three dimensional details; in the case of the infant, it was determinant in the choice of the surgical approach.

We report some variants, anomalies and aneurysms of the coronary artery tree observed in patients referred to our radiology department for suspected or known coronary artery diseases. 265 patients, with heart rate70 beats per minute and stable clinical conditions, underwent 64-MSCT. They were intravenously given contrast medium followed by saline as a chaser. Images and data were reconstructed and evaluated by two radiologists. Seven out of these patients (5 males and two females) were found to have abnormalities (variants or anomalies) of coronary arteries or coronary aneurysms, with an incidence respectively of 1.88% and 0.75%. Two patients had an anomalous origin of the left coronary artery from the pulmonary artery, as previously described (Castorina S et al., 2008). As regards the other patients, one had separate origins of the anterior descendant and circumflex arteries from the left lateral sinus with two ostia, one had quadrifurcation of the left coronary trunk, one had agenesis of the left coronary ostium and trifurcation of the right coronary artery and two had coronary aneurysms. Images acquired by 64-MSCT, because of their spatial dislocation, permit anatomical study from different perspectives. Our data confirm the ability of MSCT to evaluate, in a few seconds, anomalies of coronary arteries offering additional information for a more complete diagnosis.