Leiomyosarcoma of the inferior vena cava as etiology of chronic abdominal pains – a case report

Abstract

Inferior vena cava leiomyosarcomas are rare tumors that account for less than 0.7% of all retroperitoneal leiomyosarcomas. They are more common in women and cause nonspecific chronic abdominal pain. In this report, we present the case of a 53-year-old female patient complaining of chronic nonspecific periumbilical abdominal pain with initial onset 8 months previously who was diagnosed with inferior vena cava leiomyosarcoma by computed tomography angiography. The patient was treated with complete resection of the tumor and reconstruction of the inferior vena cava with interposition of a Dacron prosthetic graft. The treatment considered the gold standard consists of complete surgical excision, because these tumors are resistant to chemotherapy and radiotherapy. The prognosis of these patients is closely related to early diagnosis. Therefore, it is very important that vascular and general surgeons know that this disease is a possible differential diagnosis of chronic abdominal pains.

Inferior vena cava resection for a leiomyosarcoma: A case report

“…Leiomyosarcoma of the inferior vena cava (IVC) is an exceedingly rare tumor that originates in the smooth muscle cells of the vena cava wall. They account for around 0,7 % of cases of retroperitoneal leiomyosarcomas [9] . Approximately 500 cases of leiomyosarcomas have been described in the literature [10] , [11] .…”

“…In fact, abdominal CT-scan with contrast and magnetic resonance angiography are the cornerstone of the diagnosis [17] . They are helpful tools to visualise the tumor, reveal invasion of adjacent organs, detect malignant lymphatic nodes and seek for metastases involving the liver, lungs and bones [9] . Therefore, radiology is mandatory to plan the treatment strategy [15] , [18] .…”

“…Data regarding the efficiency of these therapeutics as a stand-alone treatment or combined to surgery are controversial [22] , [23] . They are generally used in metastatic situations [9] . In our patient, we decided to not conduct adjuvant chemotherapy or radiotherapy as the tumor was a low-grade leiomyosarcoma and the benefits of these therapies after clear margins on the specimen are not well-described in literature [19] .…”