Surgical Resection of a Leiomyosarcoma of the Inferior Vena Cava Mimicking Hepatic Tumor

Abstract

Introduction. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in the inferior vena cava (IVC). They are malignant, slow-growing tumors with a poor prognosis. This paper reports on a rare case of surgical resection of an IVC leiomyosarcoma mimicking a hepatic tumor. Case Presentation. A 65-year-old Japanese male was admitted for evaluation of an abdominal tumor. Enhanced computed tomography of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images, with no enhancement or washout in late-phase images. We diagnosed this tumor as either a hepatic tumor in the Spiegel lobe or a retroperitoneal tumor such as leiomyosarcoma or liposarcoma and performed a laparotomy. On the basis of surgical findings, we extirpated the tumor by performing a wedge resection of the wall of the IVC and suturing the primary IVC wall. Pathological findings led to a further diagnosis of the tumor as a leiomyosarcoma originating in the IVC. Thirty-seven months after the operation, multiple liver and lung metastases were detected, and the patient died from multiple organic failures. Conclusion. We experienced a rare case of a leiomyosarcoma of IVC mimicking hepatic tumor.

Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

“…We also performed a PubMed literature search of the past 10 years by entering the search terms ‘leiomyosarcoma’ and ‘inferior vena cava’ [3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, …”

Mesenchymal tumour of the inferior vena cava

“…The treatment modality of choice aff ording the best chance of long-term survival and even cure is aggressive surgical resection with or without caval reconstruction in combination with chemotherapy and/or radiotherapy, as recurrence is common [1,10,11]. The publication of the international registry by Mingoli et al is the literature that is most commonly cited in the management of IVC leiomyosarcoma [1].…”

“…In order to facilitate a more complete resection by decreasing tumour size, pre-operative neoadjuvant therapy has been employed. In cases where this is not possible, aggressive cyto-reductive surgery with post-operative radiotherapy provides a satisfactory palliative option [11,14].…”

Primary Hepatic Leiomyosarcoma - A Case Report With Review of Literature

“…The efficacy of chemotherapy and radiotherapy for leiomyosarcoma is extremely low. Additionally, postoperative therapy and management of recurrence are not established [12]. Despite being slow growing and having late metastasis, leiomyosarcomas carry poor prognosis and high incidence of local recurrence.…”