Leiomyosarcoma of the inferior vena cava--a case report.
This paper presents a patient successfully treated for leiomyosarcoma of the vena cava, with no recurrence or symptoms on an 8-year follow-up. A 56-year-old woman presented with chronic and progressive periumbilical and right upper abdominal pain. Physical examination and laboratory tests revealed no abnormalities. Computed tomography showed a high-density image inside the vena cava. Cavography showed a filling defect with complete occlusion of the vena cava involving the renal veins and greatly developed collateral circulation through lumbar veins. Laparotomy was performed and a large caval mass involving the renal veins was dissected and resected. Venous reconstruction was undertaken using a 19-mm bovine pericardium prosthesis (Labcor, MG-Brazil) interposed as a substitute to the vena cava, and the renal veins were anastomosed to the side of the graft. Pathologic examination confirmed a leiomyosarcoma with free surgical margins. The postoperative course was uneventful and the patient was discharged on postoperative day 8. The venous flow through the inferior vena became normal, as confirmed by later cavography. This paper presents a case of successfully managed leiomyosarcoma of the vena cava with a thorough review of the literature. The treatment of such patients and the use of bovine pericardium are also discussed.
Bonamigo
Telmo Pedro
TP
Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Irmandade Santa Casa de Misericórdia de Porto Alegre, Vascular Surgery Department, Porto Alegre, RS, Brazil.
Becker
Monica
M
Faccini
Felipe Puricelli
FP
Cantisani
Guido Pio Gracco
GP
Pereira
Wagner Michael
WM
de Napoli
Gilberto
G
de Oliveira Ilha
Darcy
D
D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000601:surgery*; D008875:Middle Aged; D012082:Renal Veins / Q000473:pathology; D019043:Vascular Neoplasms / Q000601:surgery*; D014682:Vena Cava, Inferior