Leiyomyosarcoma of the inferior vena cava with right renal invasion: about a case report

Abstract

Background Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor that develops from the wall of the IVC and can be confused with many other retroperitoneal tumors. We report the observation of a man with leiomyosarcoma of the vena cava which invades the right kidney. Case presentation 56-year-old man who has seen progress for right back pain for over a year. His thoraco-abdominal-pelvic scanner found a right tumor process measuring 18 × 13 × 18 cm invading the right kidney and the inferior vena cava, heterogeneous in nature, which is enhanced after injection of iodinated contrast product, pushing back the liver and the gall bladder. A border of separation persisted between the mass and the abdominal and thoracic walls. His biological assessment was normal. He underwent an open right nephrectomy with intraoperative bleeding requiring a transfusion of 2 red blood cells. The patient's follow-up period was 8 months without local recurrence or secondary localization. Conclusion The LMS of IVC is a tumor whose management is not yet well codified. Surgery is the only therapeutic means that gives good results, when it is possible. But long-term recurrences remain frequent, which therefore requires prolonged monitoring of these patients.

Leiomyosarcoma of the Inferior Vena Cava Presenting as a Renal Mass: A Case Report

“…These findings reveal elongated, spindle-shaped cells arranged in a bush and positive for alpha-smooth muscle actin, vimentin, and desmin [15]. In the current case, histo tumor cells may also be positive for CD34 (Bilgo et al, 2021) [1] and epithelial membrane antigens [16]. Immunohistochemical findings are negative for CD117 and the ki-67 proliferative index is low [17].…”

“…According to Webb et al [14], diagnostic features of LMS on a CT include the sign of imperceptible cava lumen, which is useful in identifying retroperitoneal mass. A biopsy is not required if the mass is removable [1]. In the present case, MRI urography, CT angiography, and renal cortical scintigraphy were used to aid in identifying and diagnosis the tumor.…”

“…Histological and immunohistochemical findings are used to make a definitive diagnosis of LMS [1]. These findings reveal elongated, spindle-shaped cells arranged in a bush and positive for alpha-smooth muscle actin, vimentin, and desmin [15].…”

“…Diagnosis is difficult, particular in the presence of a predominant extraluminal component [1]. Due to the diagnosis rarity of LMS, no imaging protocols currently exist, and no studies have compared the accuracy of CT versus MRI in diagnosing LMS [8].…”

“…Leiomyosarcoma (LMS) are rare tumors, accounting for just 6% of all sarcomas [1]. Currently, around600 cases of LMS of the inferior vena cava (IVC) have been reported worldwide [2,3].…”