Scalp Metastasis from Caval Leiomyosarcoma: an Unusual Site of Metastasis in a Rare Tumor

Leiomyosarcomas (LMS) of vascular origin, particularly those arising from the inferior vena cava (IVC), are rare and challenging tumors. This report presents a case of a 35-year-old woman with LMS of the IVC, who initially presented with generalized abdominal pain. Imaging revealed a solid mass lesion arising from the IVC, with no evidence of distant metastasis. The patient underwent en bloc mass excision with IVC resection, resulting in negative margins. After a disease-free interval of 34 months, she developed distant metastases in the scalp and right popliteal fossa. The scalp lesion was confirmed as LMS metastasis, and the patient received palliative systemic therapy. This case highlights the rarity of cutaneous metastases in LMS and underscores the importance of clinical vigilance in detecting such recurrences.