Surgical Treatment of Retroperitoneal Leiomyosarcoma Invading the Inferior Vena Cava: Report of Three Cases

Abstract

Retroperitoneal leiomyosarcoma is a rare neoplasm for which complete surgical removal provides the only effective treatment, as local recurrence adversely affects prognosis. However, invasion of major vessels may occur, making complete resection difficult. This report describes the cases of three patients who required concomitant resection of parts of the inferior vena cava because of direct tumor invasion. The major vessels should be isolated in preference to the tumor capsule during surgery to prevent sudden exsanguination or incomplete tumor resection. Resection of a recurrent sarcoma or a solitary metastasis can be effective in selected patients.

Prosthetic Replacement of the Infrahepatic Inferior Vena Cava for Leiomyosarcoma

“…8,21,22 The role of neoadjuvant or adjuvant therapy is still unclear, 4 and statistical evidence of any benefit from radiation therapy and chemotherapy in reducing recurrences is still lacking. 6,23,24 Several malignancies of different origin may extend to the infrahepatic IVC, including lymphoma, renal cell carcinoma, Wilms tumor, adrenal tumors, hepatic carcinoma, retroperitoneal metastatic lymph nodes, and different retroperitoneal sarcomas. 1,9,[25][26][27][28][29] Among all of them, leiomyosarcoma is associated with good survival despite its vascular origin and emanation from a potentially major conduit for metastatic dissemination.…”

Pelvic Leiomyosarcoma obstructing vaginal opening — case report

“…Prior to surgery, it is important to exclude the infiltration of large blood vessels. Several cases of large blood vessel involvement however, were described in the literature (iliac artery and vein, inferior vena cava, and even ovarian vein [7][8][9]. Preoperative evaluation is of particular importance for the planning of a surgical approach and procedures, in order to achieve an appropriate wide resection, which is crucial for the prevention of local recurrence and successful outcome [6].…”

Surgical Technique of Removal of Inferior Vena Cava Leiomyosarcoma Extending into the Right Atrium without Deep Hypothermic Circulatory Arrest

“…They often present with nonspecific symptoms of abdominal pain, fever, weakness, anorexia, vomiting, and night sweats. Less commonly, they present as Budd‐Chiari syndrome 1,6,7 …”