Primary leiomyosarcoma of the inferior vena cava: A case report and review of the literature

Abstract

Sixty-six cases of leiomyosarcoma of the inferior vena cava (IVC) have been reported. We present another case and review the characteristics and treatment of this rare tumor. IVC leiomyosarcomas spread by extension into adjacent tissue planes. Direct extension into the heart is known, but not into the kidneys, adrenals, or bowel. IVC leiomyosarcomas arising below the renal vein cause pain in the right-lower quadrant, back, and flank, and varying degrees of lower extremity edema; those arising in the middle caval segment cause right-upper-quadrant pain and sometimes renovascular hypertension; those arising above the hepatic vein cause varying manifestations of the Budd-Chiari syndrome. A reasonable approach to early diagnosis involves oral and intravenous contrast studies followed by computed tomography, angiography, and vena cavography. Aggressive surgical treatment is optimal in light of the tumor's slow growth pattern and relatively low malignant potential. (Metastases have been reported in fewer than 50% of cases). Tumors involving the lower IVC are most amenable to surgery; extensive collateral venous drainage of the left kidney preserves renal function during resection of middle caval tumors. Upper caval leiomyosarcomas are the least amenable to complete removal. Postoperative survival of all patients has ranged from a few weeks to eight years.

Leiomyosarcoma of inferior vena cava complicated by Budd-Chiari syndrome and disseminated intravascular coagulation — case report

“…Symptoms can vary according to the level of IVC invasion: lower segment includes the area below the renal veins (34%), middle segment consists of the area between the renal and hepatic veins (42%) and upper segment that extends from the entry of the hepatic veins up to the right atrium (24%) [3,12]. Those tumors that arise in the lower segment cause rightlower quadrant abdominal pain, back pain and lower extremities edema [13]. Localization in the middle segment causes right-upper-quadrant abdominal pain and sometimes renovascular hypertension [13].…”

“…Those tumors that arise in the lower segment cause rightlower quadrant abdominal pain, back pain and lower extremities edema [13]. Localization in the middle segment causes right-upper-quadrant abdominal pain and sometimes renovascular hypertension [13]. Budd-Chiari syndrome is a rare presentation of tumors that invade IVC above hepatic veins [13].…”

“…Localization in the middle segment causes right-upper-quadrant abdominal pain and sometimes renovascular hypertension [13]. Budd-Chiari syndrome is a rare presentation of tumors that invade IVC above hepatic veins [13]. If the IVC tumor invades, right atrium arrhythmias, dyspnea, new heart murmurs and heart failure could be observed [3,5].…”

Leiomyosarcoma of the Abdominal Aorta: A Rare Cause of Renovascular Hypertension

“…Seitaro IGUCHI 1) , Bassam ALCHI 1) , Katsuaki ASAKAWA 1) , Daisuke IZUMI 2) , Takeshi KASHIMURA 2) , Mitsuhiro UENO 1) , Farah SAFAR 3) , Shinichi NISHI 1) , Ichiei NARITA 1) , and Fumitake GEJYO 1) Introduction Leiomyosarcoma is a rare malignant tumor originating from the smooth muscle cells. Vascular leiomyosarcoma constitutes about 2% of all leiomyosarcomas and involves veins five times more than arteries (1,2).…”

Vasküler Lei̇omyosarkomlar

“…Kemoterapi tavsiye edilen hasta takipten çıktı. (4,10). Şişlik, ağrı ve özellikle alt ekstremite lezyonlarında ödem başlıca klinik bulgulardır (2,4,7).…”