Fainting as an unusual presentation of a large inferior vena cava leiomyosarcoma.
OBJECTIVE
Primary tumors of the inferior vena cava are rare, with leiomyosarcoma representing the vast majority.


METHODS
A 60-year-old man was admitted in emergency for fainting and mild anemia. A whole-body computed tomography revealed a retroperitoneal mass of approximately 8 cm in diameter, invading the lumen of the inferior vena cava, extending to the renal vein confluence. An en bloc resection of the solid mass was performed. Macroscopically the tumor did not seem to insist on the resection margin.


RESULTS
Histopathological examination confirmed the diagnosis of leiomyosarcoma of the inferior vena cava. Postoperative recovery was uneventful and the patient was discharged after eight days, starting adjuvant chemotherapy. During the follow-up, the patient did not show other fainting episode, and at 24 months he is disease free.


CONCLUSIONS
Unusually, fainting could even be the isolated sign of a large leiomyosarcoma of the inferior vena cava, also when it affects its middle portion.
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro" of Bari, Italy.
Giuseppe Massimiliano
GM
De Luca
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro" of Bari, Italy.
Angela
A
Gurrado
Department of Emergency and Organ Transplantation, Unit of Pathology, University Medical School "A. Moro" of Bari, Italy.
Andrea
A
Marzullo
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro" of Bari, Italy.
Giuseppe
G
Piccinni
Department of Emergency and Organ Transplantation, Unit of General Surgery, University Medical School "A. Moro" of Bari, Italy.
Riccardo
R
Memeo
Department of Biomedical Sciences and Human Oncology, Unit of Clinical Medicine, University Medical School "A. Moro" of Bari, Italy.
Angelo
A
Vacca
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro" of Bari, Italy mario.testini@uniba.it.
Mario
M
Testini
D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000601:surgery; D014682:Vena Cava, Inferior / Q000601:surgery*
Surgery; vascular surgery; vena cava; venous disease; venous tumors