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disease so an Ultrasound (US) was done which demonstrated no abnormality. It however revealed an incidental finding of 10 * 5 cm mass in the right pararenal area. Subsequently, a CT scan was done which revealed a 10.8 * 7.5 * 6.1 cm right “Para-renal” mass with compression of inferior vena cava and moderate right hydronephrosis, (Figure 1, 2). Abdomen MRI shows 11 * 6 * 8 cm with high signal intensity and adherent to the IVC. The initial impression of her treating physician was that of an adrenal tumor.

Challenging Inferior Vena Cava Leiomyosarcoma: A Case Report and Literature Review of Management