Leiomyosarcoma of the inferior vena cava: A case report of a rare tumor entity.

Autor: Keller, Kira, Jacobi, Barbara, Jabal, Mahmoud, Stavrou, Gregor Alexander
Zdroj: International Journal of Surgery Case Reports; 2020, Vol. 71, p50-53, 4p
Abstrakt: • Leiomyosarcoma is a rare tumor accounting for less than 1% of adult malignancies. • So far, only approximately 450 cases have been reported in literature. • Surgical resection is the treatment of choice. • Case report of a patient with leiomyosarcoma originating from the inferior vena cava. • The patient is free of disease recurrence 24 months after surgery. Leiomyosarcomas are rare and heterogeneous group of tumors that account for less than 1% of adult malignancies. More than 50% of all vascular leiomyosarcomas occur in the lower part of vena cava. Since the first description of Perl and Virchow in 1871, only approximately 450 cases have been reported in literature. The patient presented due to abdominal pain and weight loss. Based on the imaging evaluations a retroduodenal tumor with compression of the inferior vena cava was observed. In the explorative laparotomy a leiomyosarcoma originating from the inferior vena cava was identified. Considering the extensive intramural and intraluminal tumor manifestation, the patient underwent a segmental resection of the vena cava. Reconstruction was achieved by implanting a polytetrafluoroethylene (PTFE) prosthesis. Postoperatively a stenosis developed due to a pericaval haematoma with consecutive compression of the prosthesis. An angiographic implantation of a stent was successfully performed. In the 24-month follow-up, the patient is free of symptoms and tumors. Leiomyosarcomas of the vena cava are classified anatomically according to their relationship to the liver and renal vessels. The clinical symptoms depend on the affected segment. The therapy of choice is radical en bloc tumor resection. After resection, the options for reconstruction include placement of a synthetic graft, primary repair and patch repair. Due to a variety of topographic and tumor biological sarcoma manifestations, no standard has been established for the resection of this entity. The extent of resection should be planned individually. [ABSTRACT FROM AUTHOR]
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