title: Tumor thrombectomy without bypass for low-grade malignant tumors extending into the inferior vena cava: report of two cases.
abstract: Endometrial stromal sarcoma (ESS) rarely extends into the inferior vena cava (IVC). Two cases of ESS extending into the IVC were encountered. In the first case a low-grade sarcoma and cavography revealed the tumor thrombus to extend to just below the left renal vein from the right internal iliac vein, and the IVC was patent. A tumor thrombectomy was accomplished to prevent pulmonary embolism (PE) and to achieve a good prognosis. The second case was also a low-grade sarcoma. Abdominal computed tomography scanning revealed a large thrombus extending into the IVC just below the hepatic vein. A tumor thrombectomy with an IVC resection was performed. The postoperative course was uneventful for both cases. Aggressive surgical treatment is thus recommended to excise a tumor thrombus with or without an IVC resection in patients with ESS of low-grade malignancy extending into the IVC to prevent sudden death due to PE.
authors.affiliation: Department of Vascular and Applied Surgery, Tokyo Medical and Dental University, Graduate School, 1-5-45 Yushima, Tokyo, 113-8519, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Jibiki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Inoue
authors.forename: Norihide
authors.initials: N
authors.lastname: Sugano
authors.forename: Takehisa
authors.initials: T
authors.lastname: Iwai
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Katou
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011655:Pulmonary Embolism / Q000517:prevention & control; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D019043:Vascular Neoplasms / Q000473:pathology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*