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Lazar D, Stefan D, Marko D, Zlatanovic P, Sladojevic M, Ilijas C, Grubor N, Andreja D. Case series of the inferior vena cava primary leiomyosarcoma treatment. J Surg Case Rep 2024; 2024:rjad546. [PMID: 38840898 PMCID: PMC11151786 DOI: 10.1093/jscr/rjad546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 06/07/2024] Open
Abstract
Tumors of the inferior vena cava (IVC) are rare and usually malignant and they can be primary and secondary. The most common primary tumor of the IVC is primary leiomyosarcoma. The first case of primary IVC leiomyosarcoma has been described in 1871 [1].The total number of 218 cases has collected until 1996 [2]. After that, three large single center series of these tumors emerged [3-5]. Present a series of five cases of these tumors. All the patients underwent a wide complete resection of tumors and the reconstruction with Dacron grafts. One patient died 19 months after the surgery, while the remaining ones survived without a local and system disease relapse. Although a surgical resection combined with the chemotherapy is often not curative, it can achieve a significant long-term survival. For this reason, we recommend the aggressive surgical management using the modern vascular surgical and oncology techniques.
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Affiliation(s)
- Davidovic Lazar
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Koste Todorovića Street 8, Belgrade 11000, Serbia
| | - Ducic Stefan
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragas Marko
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Koste Todorovića Street 8, Belgrade 11000, Serbia
| | | | - Milos Sladojevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Koste Todorovića Street 8, Belgrade 11000, Serbia
| | - Cinara Ilijas
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikica Grubor
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Digestive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Dimic Andreja
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Koste Todorovića Street 8, Belgrade 11000, Serbia
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2
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Not All Leiomyosarcomas Are the Same: How to Best Classify LMS. Curr Treat Options Oncol 2023; 24:327-337. [PMID: 36884163 DOI: 10.1007/s11864-023-01067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/09/2023]
Abstract
OPINION STATEMENT Leiomyosarcoma arises from smooth muscle and represents one of the most common soft tissue sarcomas. Despite aggressive multimodality care, over half of the patients will ultimately develop metastatic and incurable disease with a median survival of 12-18 months. At present, there is no standard system to classify leiomyosarcoma, which itself is a heterogeneous disease. Classification by tumor location is the most simplistic approach and is most frequently utilized in clinical practice. Tumor location impacts diagnosis (recognition pre-operatively versus at the time of surgery) as well as treatment (ability to completely resect with clear margins with minimal morbidity). While tumor location can impact prognosis, for example, extremity tumors would generally be considered as lower risk than inferior vena cava tumors, leiomyosarcoma can exhibit a heterogeneous behavior irrespective of tumor location. Specifically, some patients have rapidly progressing disease despite aggressive chemotherapy, while others display a more indolent course even in the metastatic setting. The pathogenic drivers of the heterogeneity observed in tumor behavior are not well understood. As we learn more about the molecular composition of leiomyosarcoma, various classification groups have been proposed as discussed here. Ultimately, it is unlikely that one variable will be adequate for tumor classification, and a combination of location and molecular composition will be necessary to develop appropriate risk stratification nomograms and treatment strategies.
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3
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BORGHI A, SCOTTO DI UCCIO A, GRONCHI A. Primary malignancy of the inferior vena cava, a review of surgical treatments and outcomes. THE JOURNAL OF CARDIOVASCULAR SURGERY 2022; 63:649-663. [DOI: 10.23736/s0021-9509.22.12418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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4
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Tumors of the cardiovascular system: heart and blood vessels. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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5
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Sheaffer WW, Davila VJ, Mendes BC, Meltzer AJ, Stone WM, Soh IY, Truty MJ, Nagorney DM, Money SR, Bower TC. Surgical and reconstructive outcomes in primary venous leiomyosarcoma. J Vasc Surg Venous Lymphat Disord 2021; 10:901-907. [PMID: 34352417 DOI: 10.1016/j.jvsv.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/22/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Primary venous leimyosarcomas (PVL) are rare and pose challenges in surgical management. This study evaluates the clinical outcomes and identifies predictors of survival in our surgical series of PVL. METHODS A retrospective review was performed of patients who had resection of PVL at three centers between 1990-2018. Patient demographics, comorbidities, intraoperative data, survival, and graft related outcomes were recorded. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression. RESULTS Seventy patients with a diagnosis of PVL were identified between 1990 and 2018. Fifty-four patients (77%) had PVL of the IVC and 16 (23%) had peripheral PVL. Mean follow up for the series was 55.0 months (range 1-217 months). Fifty one patients (96%) with IVC PVL needed caval reconstruction and 3 (4%) had resection only. There were no deaths within thirty days of surgery. Five patients (9%) required early re-intervention including one (2%) IVC stent. Sixteen peripheral PVL were identified. Eight patients (50%) had venous reconstructions performed and 8 (50%) had the vein resected without reconstruction. There were no deaths within thirty days. Five year survival was 57.5% for IVC PVL and 70.0% for peripheral PVL . Kaplan-Meier survival analysis for IVC and peripheral PVL revealed no difference in overall survival (p = 0.624) at 5 years. CONCLUSIONS PVL is a rare and aggressive disease even with surgical resection. We found no difference in survival between IVC and peripheral lesions suggesting aggressive management is warranted for PVL of any origin. Management of PVL requires a multidisciplinary approach to provide patients with the best long term outcomes.
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Affiliation(s)
- William W Sheaffer
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054.
| | - Victor J Davila
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Bernardo C Mendes
- Mayo Clinic Rochester Division of Vascular Surgery, 200 First St. SW, Rochester, MN 55905
| | - Andrew J Meltzer
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - William M Stone
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Ina Y Soh
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Mark J Truty
- Mayo Clinic Rochester Department of General Surgery Subspecialties, 200 First St. SW, Rochester, MN 55905
| | - David M Nagorney
- Mayo Clinic Rochester Department of General Surgery Subspecialties, 200 First St. SW, Rochester, MN 55905
| | - Samuel R Money
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Thomas C Bower
- Mayo Clinic Rochester Division of Vascular Surgery, 200 First St. SW, Rochester, MN 55905
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Alslaim H, Chung J, Kruse E, Shukla M, Agarwal G. Iatrogenic Inferior Vena Cava Resection Requiring Reconstruction. Vasc Endovascular Surg 2021; 55:864-868. [PMID: 33906552 DOI: 10.1177/15385744211012904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This is a report of an iatrogenic inferior vena cava (IVC) segmental resection and reconstruction utilizing bovine pericardium. A 48-year-old female patient presented for a planned right nephrectomy by the urology service secondary to xanthogranulomatous pyelonephritis. This was complicated by inadvertent resection of an 8 cm segment of the infrarenal IVC. Postoperatively, the patient did not tolerate IVC ligation due to severe lower extremity edema. She then underwent reconstruction with a bovine pericardium conduit as an interposition graft. The post-operative course was complicated by pulmonary embolism requiring percutaneous intervention. This report addresses the utility of bovine pericardium for IVC reconstruction in an infected field.
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Affiliation(s)
- Hossam Alslaim
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Jane Chung
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Edward Kruse
- Division of Surgical Oncology, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Mrinal Shukla
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Gautam Agarwal
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
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7
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Gaignard E, Bergeat D, Robin F, Corbière L, Rayar M, Meunier B. Inferior Vena Cava Leiomyosarcoma: What Method of Reconstruction for Which Type of Resection? World J Surg 2021; 44:3537-3544. [PMID: 32445073 DOI: 10.1007/s00268-020-05602-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Inferior vena cava leiomyosarcoma (IVCL) is a rare tumor with a poor prognosis, and its surgical resection remains a challenge. To date, surgery is the only potentially curative treatment for IVCL with a 5-year survival rate of 55%. The main challenge is to combine oncological surgery with clear margins and vascular reconstruction of the inferior vena cava (IVC). In this review, we discuss the different approaches to vascular reconstruction after IVCL resection, using a prosthetic or autologous patch, direct suture or simple ligation without IVC reconstruction. The reconstruction of IVC depends of tumor location and its extension. We recommend no reconstruction if venous collaterality is well-established. When vascular reconstruction is required, we prefer prosthetic PTFE graft. These patients should be referred to high-volume centers with a multidisciplinary team of sarcoma surgeons with cardiothoracic, vascular and hepatic specialties.
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Affiliation(s)
- Elodie Gaignard
- Service de Chirurgie hépatobiliaire Et Digestive, CHU Rennes, 2 Rue Henri le Guilloux, 35000, Rennes, France.
- Université de Rennes, 35000, Rennes, France.
| | - Damien Bergeat
- Service de Chirurgie hépatobiliaire Et Digestive, CHU Rennes, 2 Rue Henri le Guilloux, 35000, Rennes, France
- Université de Rennes, 35000, Rennes, France
- UMR Inserm 1241, NuMeCan, Nutrition Metabolisme Et Cancer, 35000, Rennes, France
| | - Fabien Robin
- Service de Chirurgie hépatobiliaire Et Digestive, CHU Rennes, 2 Rue Henri le Guilloux, 35000, Rennes, France
- Université de Rennes, 35000, Rennes, France
- UMR Inserm 1241, NuMeCan, Nutrition Metabolisme Et Cancer, 35000, Rennes, France
| | - Lisa Corbière
- Service de Chirurgie hépatobiliaire Et Digestive, CHU Rennes, 2 Rue Henri le Guilloux, 35000, Rennes, France
- Université de Rennes, 35000, Rennes, France
| | - Michel Rayar
- Service de Chirurgie hépatobiliaire Et Digestive, CHU Rennes, 2 Rue Henri le Guilloux, 35000, Rennes, France
- Université de Rennes, 35000, Rennes, France
| | - Bernard Meunier
- Service de Chirurgie hépatobiliaire Et Digestive, CHU Rennes, 2 Rue Henri le Guilloux, 35000, Rennes, France
- Université de Rennes, 35000, Rennes, France
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8
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Zhang XX, Zhu JQ, Zhang H, Kou JT, Ma J, He Q. Resection of a retrohepatic leiomyosarcoma of the inferior vena cava combined with caudate lobectomy and reconstruction with an allogenic vein. Hepatobiliary Pancreat Dis Int 2021; 20:80-82. [PMID: 32847742 DOI: 10.1016/j.hbpd.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/05/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Xin-Xue Zhang
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Ji-Qiao Zhu
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Zhang
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Jian-Tao Kou
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Jun Ma
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Qiang He
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
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9
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Grieff AN, Hamilton C, Ady J, Beckerman WE, Shafritz R, Koshenkov V, Rahimi S. Concomitant Aorto-Caval Reconstruction for Inferior Vena Cava Leiomyosarcoma. Ann Vasc Surg 2020; 70:567.e13-567.e17. [PMID: 32795651 DOI: 10.1016/j.avsg.2020.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Leiomyosarcoma of the inferior vena cava (IVC) is a rare smooth muscle neoplasm typically presenting in the fifth to sixth decades of life with both intraluminal and extraluminal growth patterns. Surgical resection remains the gold standard for nonmetastatic disease and often requires vascular reconstruction. We present an atypical case of leiomyosarcoma involving both the IVC and infrarenal abdominal aorta necessitating reconstruction with intraoperative veno-venous bypass. METHODS A 63-year-old man initially presenting with back pain was found to have a large mass adjacent to the IVC on MRI, subsequently confirmed to be leiomyosarcoma by biopsy. After 6 months of neoadjuvant chemotherapy, the patient was taken for resection. However, intraoperatively the tumor was found to involve the aorta necessitating combined aorto-caval reconstruction. To facilitate en-bloc resection of the tumor, the aorta was reconstructed first followed by the inferior vena cava using veno-venous bypass. RESULTS Postoperatively, the patient was taken to the intensive care unit for resuscitation and had an uncomplicated hospital course. He was discharged to rehab 6 days postoperatively and at one year remains free of significant tumor burden with patent aorto-caval bypass grafts. CONCLUSIONS Primary leiomyosarcoma of the IVC is estimated to have aortic involvement in <10% of cases and concurrent aorto-caval reconstruction can be a well-tolerated option in good surgical candidates. Furthermore, veno-venous bypass can be a useful tool for accomplishing successful oncologic resections. With interdisciplinary collaboration between surgical oncologists, urologists, and vascular surgeons, difficult pathologies can be addressed with good patient outcomes.
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Affiliation(s)
- Anthony N Grieff
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Charles Hamilton
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Justin Ady
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - William E Beckerman
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Randy Shafritz
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Vadim Koshenkov
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Saum Rahimi
- Department of Vascular Surgery and Endovascular Therapy, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
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10
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Dyspnea due to an uncommon vascular tumor: leiomyosarcoma of the infrahepatic vena cava inferior. Surg Case Rep 2020; 6:136. [PMID: 32548741 PMCID: PMC7297879 DOI: 10.1186/s40792-020-00896-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background Leiomyosarcoma (LMS) of the inferior vena cava (IVC) is a rare malignancy that originated from the smooth muscle tissue of the vascular wall. Diagnoses, as well as, treatment of the disease are still challenging and to date, a radical surgical resection of the tumor is the only curative approach. Case report We report on the case of a 49-year old male patient who presented with suddenly experienced dyspnea. Besides bilateral pulmonary arterial embolism, a lesion close to the head of the pancreas was found using CT scan, infiltrating the infrahepatic IVC. Percutaneous ultrasound-guided biopsy revealed a low-grade LMS. Intraoperatively, a tumor of the IVC was observed without infiltration of surrounding organs or distant metastases. Consequently, the tumor was removed successfully, by en-bloc resection including prosthetic graft placement of the IVC. Histological workup revealed a completely resected (R0) moderately differentiated LMS of the IVC. Conclusion LMS of the infrahepatic IVC is an uncommon tumor, which may present with dyspnea as its first clinical sign. Patients benefit from radical tumor resection. However, due to the poor prognosis of vascular LMS, a careful follow-up is mandatory.
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11
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Karaosmanoglu AD, Onur MR, Uysal A, Akata D, Ozmen MN, Karcaaltincaba M. Tumor in the veins: an abdominal perspective with an emphasis on CT and MR imaging. Insights Imaging 2020; 11:52. [PMID: 32215762 PMCID: PMC7096619 DOI: 10.1186/s13244-020-00854-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Endovenous tumor thrombus in abdomen should be accurately diagnosed as it is a significant finding that may change medical and surgical treatment approaches. As some underlying reasons for endovenous tumor thrombi are relatively rare and imaging findings may be quite subtle, they can be easily overlooked which may have important clinical consequences. In this paper, we described the various imaging aspects of endovenous tumor thrombi originating from various tumor types in different venous structures of the abdomen.
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Affiliation(s)
| | - Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey.
| | - Aycan Uysal
- Department of Radiology, Gulhane Training and Research Hospital, 06010, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
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12
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Bajaj G, Tirumani H, Whisman MK, Raichandani S, Ram R, Jambhekar K, Gardner JM, Pandey T. Comprehensive Review of Abdominopelvic Mesenchymal Tumors with Radiologic Pathologic Correlation and Update on Current Treatment Guidelines - Part 1. Semin Ultrasound CT MR 2020; 41:222-238. [PMID: 32446433 DOI: 10.1053/j.sult.2020.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies accounting for only 1% of all solid adult malignancies. These have been categorized in 12 broad groups by the World Health Organization (WHO) with their recent update in 2013. Majority of them lack specific imaging features serving as imaging conundrums for a radiologist. These are often large masses at presentation as they are asymptomatic or cause vague clinical symptoms. These tumors are challenging for surgeons as well as they find it difficult to achieve complete resection because of complex intra-abdominal anatomy and their close relationship with critical structures. Often, a multidisciplinary approach is required to decide on the most appropriate management for these complex cases so as to provide optimal patient care. Knowledge of the WHO classification, pathologic features and available treatment options will help the radiologist make a meaningful contribution in multidisciplinary discussions of such cases and overall patient care. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor are the 3 most common primary intra-abdominal sarcomas. In part 1 of this article, general features of soft tissue sarcomas and some of the common tumors from WHO category 1-4 found in abdomen and pelvis are discussed. Part 2 will focus on common tumors from remainder of the WHO categories.
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Affiliation(s)
- Gitanjali Bajaj
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
| | - Harika Tirumani
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Michella K Whisman
- Department of Pathology and Clinical Laboratories, University of Michigan, Ann Arbor, MI
| | - Surbhi Raichandani
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Roopa Ram
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Kedar Jambhekar
- Department of Radiology and Orthopedics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Jerad M Gardner
- Department of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Tarun Pandey
- Department of Radiology and Orthopedics, University of Arkansas for Medical Sciences, Little Rock, AR
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Arif SH, Mohammed AA. Leiomyosarcoma of the inferior vena cava presenting as deep venous thrombosis; case report. Radiol Case Rep 2019; 15:133-135. [PMID: 31827658 PMCID: PMC6888706 DOI: 10.1016/j.radcr.2019.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 10/18/2019] [Accepted: 10/26/2019] [Indexed: 11/28/2022] Open
Abstract
Primary tumors arising from the inferior vena cava are extremely rare, leiomyosarcoma is the most common one arising from the smooth muscle cells in the media of the wall of the vena cava. A 42-year-old lady had epigastric pain and back pain for 4 months with signs of deep vein thrombosis of the right lower limb. CT-scan showed a mass related to the inferior vena cava which was proved by histopathological examination to be leiomyosarcoma of the inferior vena cava. A multidisciplinary team is required for the diagnosis and management of tumors the vena cava. Long term follow-up is recommended.
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Affiliation(s)
- Sardar Hassan Arif
- Department of Surgery, College of Medicine, University of Duhok, Azadi Teaching Hospital, 8 Nakhoshkhana Road, 1014 AM, Duhok City, Kurdistan Region, Iraq
| | - Ayad Ahmad Mohammed
- Department of Surgery, College of Medicine, University of Duhok, Azadi Teaching Hospital, 8 Nakhoshkhana Road, 1014 AM, Duhok City, Kurdistan Region, Iraq
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14
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Jeong S, Han Y, Cho YP, Kwon TW. Clinical Outcomes of Surgical Resection for Leiomyosarcoma of the Inferior Vena Cava. Ann Vasc Surg 2019; 61:377-383. [DOI: 10.1016/j.avsg.2019.05.053] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/01/2019] [Accepted: 05/16/2019] [Indexed: 12/17/2022]
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15
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Chiba E, Hamamoto K, Tanaka O, Watanabe F, Noda H, Rkiyama T, Omoto K. Preoperative intravascular ultrasonographic evaluation of leiomyosarcoma of the inferior vena cava: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:426-431. [PMID: 30762237 DOI: 10.1002/jcu.22710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/22/2019] [Accepted: 01/27/2019] [Indexed: 06/09/2023]
Abstract
Leiomyosarcoma of the inferior vena cava is a rare malignant tumor originating from smooth muscle cells of the vascular media. Its preoperative diagnosis by conventional noninvasive examinations such as abdominal ultrasonography, X-ray computed tomography, and magnetic resonance imaging, may be difficult because of their nonspecific findings. We present the case of a 72-year-old woman with leiomyosarcoma of the inferior vena cava diagnosed by intravascular ultrasonography.
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Affiliation(s)
- Emiko Chiba
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kohei Hamamoto
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Osamu Tanaka
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Fumiaki Watanabe
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hiroshi Noda
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshiki Rkiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kiyoka Omoto
- Department of Laboratory Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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16
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Madhavan S, Junnarkar SP, Koh NWC, Shelat VG. Inferior vena cava leiomyosarcoma in an octogenerian. Ann Hepatobiliary Pancreat Surg 2019; 23:274-277. [PMID: 31501817 PMCID: PMC6728244 DOI: 10.14701/ahbps.2019.23.3.274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/07/2018] [Accepted: 11/15/2018] [Indexed: 11/17/2022] Open
Abstract
Inferior Vena Cava (IVC) leiomyosarcoma (LM) is a rare malignancy of mesenchymal origin with an incidence of 1/100,000. We present an 82-year-old lady with a past history of open cholecystectomy who presented with a large indeterminate mass on abdominal imaging. Open resection of the mass was performed and histology with immunohistochemical staining revealed leiomyosarcoma. She received adjuvant radiotherapy and remained disease free 4 years after.
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Polytetrafluoroethylene Is a Safe and Effective Interposition Conduit for Caval Reconstruction After Resection of Primary Leiomyosarcoma of the Inferior Vena Cava. Ann Vasc Surg 2019; 58:289-294. [DOI: 10.1016/j.avsg.2018.12.068] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/30/2018] [Accepted: 12/05/2018] [Indexed: 12/29/2022]
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Outcome of iliocaval resection and reconstruction for retroperitoneal sarcoma. J Vasc Surg Venous Lymphat Disord 2019; 7:547-556. [DOI: 10.1016/j.jvsv.2018.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/26/2018] [Indexed: 11/23/2022]
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Singh D, Sarathy GP, Moodadla S. A rare case of primary leiomyosarcoma of the inferior vena cava with an intra- and extravascular component. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2019. [DOI: 10.4103/ijves.ijves_18_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Gao B, Zhou D, Qian X, Zhang W, Ying L, Wang W. Primary leiomyoma of the inferior vena cava mimicking a cystic neoplasm of the pancreas: a case report. Cardiovasc Pathol 2018; 46:107097. [PMID: 32086002 DOI: 10.1016/j.carpath.2018.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/09/2018] [Accepted: 11/26/2018] [Indexed: 11/15/2022] Open
Abstract
Benign smooth muscle tumors of the inferior vena cava (IVC) are unusual, but mostly consist of intravenous leiomyomatosis, which arises from the uterus. Primary leiomyoma of the IVC is extremely rare. Here, we report a primary leiomyoma of the IVC, misleadingly reported as a cystic neoplasm of the pancreas in images. Immunohistochemical analysis was positive for (estrogen receptor) ER and (progesterone receptor) PR, indicating gynecologic leiomyomas. The use of ER and PR immunostaining is recommended to help distinguish between somatic and gynecologic leiomyomas, whose criteria of malignancy differ.
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Affiliation(s)
- Bingqiang Gao
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dongkai Zhou
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohui Qian
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wang Zhang
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lixiong Ying
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weilin Wang
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory & Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China.
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Bednarova I, Frellesen C, Roman A, Vogl TJ. Case 257: Leiomyosarcoma of the Inferior Vena Cava. Radiology 2018; 288:901-908. [DOI: 10.1148/radiol.2018160821] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Iliana Bednarova
- From the Department of Radiology, University Hospital Udine, P.le S. Maria della Misericordia n. 15, 33100 Udine, Italy (I.B.); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Frankfurt, Germany (C.F., T.J.V.); and Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (A.R.)
| | - Claudia Frellesen
- From the Department of Radiology, University Hospital Udine, P.le S. Maria della Misericordia n. 15, 33100 Udine, Italy (I.B.); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Frankfurt, Germany (C.F., T.J.V.); and Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (A.R.)
| | - Andrei Roman
- From the Department of Radiology, University Hospital Udine, P.le S. Maria della Misericordia n. 15, 33100 Udine, Italy (I.B.); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Frankfurt, Germany (C.F., T.J.V.); and Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (A.R.)
| | - Thomas J. Vogl
- From the Department of Radiology, University Hospital Udine, P.le S. Maria della Misericordia n. 15, 33100 Udine, Italy (I.B.); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Frankfurt, Germany (C.F., T.J.V.); and Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (A.R.)
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Stilidi IS, Abgaryan MG, Kalinin AE, Berdnikov SN. [Surgical treatment of patients with leiomyosarcoma of inferior vena cava]. Khirurgiia (Mosk) 2018:4-12. [PMID: 29076476 DOI: 10.17116/hirurgia2017104-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To evaluate the results of surgical treatment of patients with leiomyosarcoma of inferior vena cava. MATERIAL AND METHODS For the period 2003-2016 21 patients with leiomyosarcoma of IVC were operated at the abdominal department of Blokhin Russian Cancer Research Center. 23.8% patients (n=5) underwent longitudinal resection of IVC, 23.8% (n=5) - circular resection and ligation of IVC, 23.8% (n=5) - circular resection and ligation of IVC, left renal vein ligation, 9.5% (n=2) - circular resection and replacement of IVC, 9.5% (n=2) - circular resection and replacement of IVC, ligation of left renal vein, 9.5% (n=2) - circular resection and replacement of IVC, left renal vein implantation into the prosthesis. RESULTS The incidence of postoperative complications was 38% (n=8). Postoperative mortality was 4.8% (n=1). R1-resection was made in 4.8% patients (n=1). 1- and 2-year recurrence-free survival was 67% and 50% respectively. Overall 1- and 2-year survival was 86% and 68% respectively. CONCLUSION In patients with leiomyosarcoma of inferior vena cava surgery is feasible and safe with satisfactory long-term results.
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Affiliation(s)
- I S Stilidi
- Blokhin Russian Cancer Research Center of Healthcare Ministry of the Russian Federation, Moscow, Russia
| | - M G Abgaryan
- Blokhin Russian Cancer Research Center of Healthcare Ministry of the Russian Federation, Moscow, Russia
| | - A E Kalinin
- Blokhin Russian Cancer Research Center of Healthcare Ministry of the Russian Federation, Moscow, Russia
| | - S N Berdnikov
- Blokhin Russian Cancer Research Center of Healthcare Ministry of the Russian Federation, Moscow, Russia
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Balaney B, Mitzman B, Fung J, Paul JD. Diagnosis and management of rare inferior vena cava leiomyosarcoma guided by a novel minimally invasive vascular biopsy technique. Catheter Cardiovasc Interv 2018; 92:752-756. [DOI: 10.1002/ccd.27535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Bhavna Balaney
- Section of Cardiology, Department of Medicine; University of Chicago; Chicago Illinois
| | - Brian Mitzman
- Section of Cardiac and Thoracic Surgery, Department of Surgery; University of Chicago; Chicago Illinois
| | - John Fung
- Section of Transplant Surgery, Department of Surgery; University of Chicago; Chicago Illinois
| | - Jonathan D. Paul
- Section of Cardiology, Department of Medicine; University of Chicago; Chicago Illinois
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24
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Coubeau L, Rico Juri JM, Ciccarelli O, Jabbour N, Lerut J. The Use of Autologous Peritoneum for Complete Caval Replacement Following Resection of Major Intra-abdominal Malignancies. World J Surg 2017; 41:1005-1011. [PMID: 27826769 DOI: 10.1007/s00268-016-3804-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Assessment of a simple layer peritoneal tube used as an autogenous inferior vena cava replacement. BACKGROUND Extensive en-bloc multivisceral resection including major vessels is effective in selected abdominal malignancies, but the need for vascular reconstruction represents a surgical challenge. We describe the use of autologous peritoneum for caval replacement. METHODS Autogenous parietal peritoneum without fascial backing was harvested and tubularized to replace the inferior vena cava (IVC) in four patients with complex abdominal tumors. Surgical morbidity was evaluated using the Clavien-Dindo classification, and graft patency was systematically evaluated with ultrasound. RESULTS All four patients had multiorgan resections for malignancies involving the retro-hepatic IVC, and they all required the replacement of infrarenal and suprarenal IVC segments. Additionally, all four required a right nephrectomy, two had a combined major hepatectomy, and one patient needed a veno-venous bypass. All had an R0 resection. A clinical follow-up took place between 5 and 11 months after surgery for each patient. Four-month graft patency was confirmed by ultra-sound and TDM with no sign of disease recurrence. CONCLUSIONS Autologous peritoneum without fascial backing is a good and safe option for circumferential replacement of IVC after extensive en-bloc tumor resection with IVC involvement.
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Affiliation(s)
- Laurent Coubeau
- Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 10 Avenue Hippocrate, 1200, Brussels, Belgium.
| | - Juan-Manuel Rico Juri
- Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 10 Avenue Hippocrate, 1200, Brussels, Belgium
| | - Olga Ciccarelli
- Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 10 Avenue Hippocrate, 1200, Brussels, Belgium
| | - Nicolas Jabbour
- Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 10 Avenue Hippocrate, 1200, Brussels, Belgium
| | - Jan Lerut
- Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 10 Avenue Hippocrate, 1200, Brussels, Belgium
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López-Ruiz JA, Tallón-Aguilar L, Marenco-de la Cuadra B, López-Pérez J, Oliva-Mompeán F, Padillo-Ruiz J. Leiomiosarcoma de vena cava inferior. Caso clínico y revisión bibliográfica. CIR CIR 2017; 85:361-365. [DOI: 10.1016/j.circir.2016.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 05/04/2016] [Indexed: 11/30/2022]
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26
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López-Ruiz JA, Tallón-Aguilar L, Marenco-de la Cuadra B, López-Pérez J, Oliva-Mompeán F, Padillo-Ruiz J. Leiomyosarcoma of the inferior vena cava. Case report and literature review. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.circen.2017.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Wu H, Zhang H, Wang S, Wu X, Dong D, Liang C. Multimodality imaging of benign or malignant tumors in the vena cava and its main branches. Clin Imaging 2017; 43:50-59. [DOI: 10.1016/j.clinimag.2016.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 10/07/2016] [Accepted: 10/17/2016] [Indexed: 01/17/2023]
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28
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Chakrabarti S, Agarwal D, Desai SM, Mehta DY. Can the Right Kidney be Salvaged in the Surgical Management of Leiomyosarcoma of the Inferior Vena Cava-a Rare Case Report. Indian J Surg Oncol 2016; 7:353-5. [PMID: 27651700 DOI: 10.1007/s13193-015-0385-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 02/23/2015] [Indexed: 10/23/2022] Open
Abstract
Primary leiomyosarcoma is rare malignant tumour arising from the smooth muscles and can appear at any site where smooth muscle is present. It is more common in the peripheral vessels and has predilection for the female sex. We here report a rare case of leiomyosarcoma involving the segment I & II of inferior vena cava with extension into the renal veins in a 70 year old male patient. Midline transperitoneal approach was taken to excise the tumour along with the vessel wall with anastomosis between the right renal vein and the infrarenal inferior vena cava with a reversed great saphenous vein graft thereby salvaging the right kidney.
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Affiliation(s)
- Suvadip Chakrabarti
- Department of Surgical Oncology, Sri Aurobindo Medical College and Post Graduate Institute, Flat 404, Akansha Apartment, SAMC & PGI Hospital campus, Sanwer, Indore-Ujjain highway, Indore, 452001 Madhya Pradesh India
| | - Deepak Agarwal
- Department of Surgical Oncology, Sri Aurobindo Medical College and Post Graduate Institute, Flat 404, Akansha Apartment, SAMC & PGI Hospital campus, Sanwer, Indore-Ujjain highway, Indore, 452001 Madhya Pradesh India
| | - Sanjay M Desai
- Department of Surgical Oncology, Sri Aurobindo Medical College and Post Graduate Institute, Flat 404, Akansha Apartment, SAMC & PGI Hospital campus, Sanwer, Indore-Ujjain highway, Indore, 452001 Madhya Pradesh India
| | - Dharmendra Y Mehta
- Department of Surgical Oncology, Sri Aurobindo Medical College and Post Graduate Institute, Flat 404, Akansha Apartment, SAMC & PGI Hospital campus, Sanwer, Indore-Ujjain highway, Indore, 452001 Madhya Pradesh India
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Giesel FL, Schoebinger M, Hosch W, von Tengg-Kobligk H, Meinzer HP, Allenberg JR, Kauczor HU, Böckler D. Images in vascular medicine. Vasc Med 2016; 10:55-7. [PMID: 15921001 DOI: 10.1191/1358863x05vm577xx] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Frederik L Giesel
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
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30
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Shen ZJ, Zhou XL, Yu YL, Li M. One case of leiomyosarcoma of the inferior vena cava treated with radical resection and vascular reconstruction. Vasc Med 2016; 10:225-7. [PMID: 16235776 DOI: 10.1191/1358863x05vm614cr] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 48-year-old Chinese woman with primary leiomyosarcoma of the inferior vena cava (IVC) who succesfully underwent resection of a long length of the affected IVC and the right kidney together with graft replacement of the IVC is reported.
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Affiliation(s)
- Zhou-Jun Shen
- Department of Urology, 1st Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
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31
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Dacron Graft Replacement with Bilateral Renal Vein Reimplantation for Inferior Vena Cava Leiomyosarcoma. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/153857449603000217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The surgical treatment of inferior vena cava (IVC) leiomyosarcomas is not well elucidated. The preferred procedures include either IVC wedge resection or ligation. The authors present a case in which Dacron graft replacement of the midportion of the IVC with bilateral renal vein implantation was performed for an IVC leiomyosarcoma. This is, to their knowledge, the first report in the literature describing a technically successful IVC Dacron graft replacement for a primary tumor. The report is presented to demonstrate the technical feasibility of this procedure and the good long-term graft patency rate. At present complete surgical excision of the tumor seems to offer the only chance for a long-term cure.
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Leiomyosarcoma of the Inferior Vena Cava: A Case Series and Review of the Literature. Ann Vasc Surg 2016; 33:245-51. [DOI: 10.1016/j.avsg.2015.10.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/04/2015] [Accepted: 10/15/2015] [Indexed: 12/20/2022]
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34
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Monteagudo Cortecero J, Guirau Rubio MD, Payá Romá A. Leiomyosarcoma of the Inferior Vena Cava:AIRP Best Cases in Radiologic-Pathologic Correlation. Radiographics 2015; 35:616-20. [DOI: 10.1148/rg.352130105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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35
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Cameliere L, Palcau L, Felisaz A, Coffin O, Gouicem D, Berger L. Intimal angiosarcoma from the common femoral vein in a 27-year-old patient. Ann Vasc Surg 2014; 29:364.e11-4. [PMID: 25463330 DOI: 10.1016/j.avsg.2014.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/02/2014] [Accepted: 09/04/2014] [Indexed: 11/19/2022]
Abstract
Intimal sarcoma is a rare and aggressive vascular pathology. The literature describes about 140 cases. Because of late diagnosis, the median survival time is only a few months. Presentations vary from the localization. The most common symptoms are intravascular obstruction or embolization. Diagnosis is difficult and vascular surgeons do not know the treatment very well. We present the first case of intimal angiosarcoma of the common femoral vein presenting with a deep venous thrombosis and discuss diagnosis and therapeutic approach.
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Affiliation(s)
- Lucie Cameliere
- Department of Vascular Surgery, CHU Caen Côte de Nacre, Caen, France
| | - Laura Palcau
- Department of Vascular Surgery, CHU Caen Côte de Nacre, Caen, France
| | - Aurélien Felisaz
- Department of Vascular Surgery, CHU Caen Côte de Nacre, Caen, France
| | - Olivier Coffin
- Department of Vascular Surgery, CHU Caen Côte de Nacre, Caen, France
| | - Djelloul Gouicem
- Department of Vascular Surgery, CHU Caen Côte de Nacre, Caen, France
| | - Ludovic Berger
- Department of Vascular Surgery, CHU Caen Côte de Nacre, Caen, France.
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Imaging features and metastatic pattern of non-IVC retroperitoneal leiomyosarcomas: are they different from IVC leiomyosarcomas? J Comput Assist Tomogr 2014; 38:687-92. [PMID: 24834891 DOI: 10.1097/rct.0000000000000097] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purposes of this study were to describe the imaging features and metastatic pattern of non-inferior vena cava (IVC) retroperitoneal leiomyosarcomas (non-IVC LMS) and to compare them with those of IVC leiomyosarcomas (IVC LMS) to assess any differences between the 2 groups. MATERIALS AND METHODS In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, all 56 patients with pathologically confirmed primary retroperitoneal leiomyosarcoma (34 non-IVC LMS and 22 IVC LMS) seen at our tertiary cancer center during a 10-year period were included. All available imaging of primary tumor (18 non-IVC LMS and 19 IVC LMS) and follow-up imaging studies (on all 56 patients) were reviewed in consensus by 2 fellowship-trained oncoradiologists. Imaging features and metastatic spread of non-IVC LMS were described and compared with those of IVC LMS. Continuous variables were compared using the Student t test, binary variables with the Fisher exact test, and survival using the log-rank test. RESULTS Non-inferior vena cava retroperitoneal leiomyosarcomas had a mean size of 11.3 cm (range, 3.7-27 cm) and most commonly occurred in the perirenal space (16/18). Primary tumors were hyperattenuating to muscle (11/18) and showed heterogeneous enhancement (17/18). Lungs (22/34), peritoneum (18/34), and liver (18/34) were the most common metastatic sites. There was no significant difference between the imaging features and metastatic pattern of non-IVC and IVC LMS. Although non-IVC LMS presented at a more advanced stage (P < 0.002), there was statistically non-significant trend toward better median survival of non-IVC LMS (P = 0.07). CONCLUSIONS Non-inferior vena cava retroperitoneal leiomyosarcomas are large heterogeneous tumors arising in the perirenal space and frequently metastasize to lungs, peritoneum, and liver. From a radiologist's perspective, non-IVC LMS behave similar to IVC-LMS.
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Kumar S, Devana SK, Kuthe S, Yadav TD, Prasad S. Giant leiomyosarcoma of inferior vena cava. A surgical challenge. Asian Cardiovasc Thorac Ann 2014; 22:858-61. [PMID: 24887825 DOI: 10.1177/0218492313487356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We describe the case of a 37-year-old woman who presented with an unusually large (26 × 20 × 16 cm) extraluminal leiomyosarcoma arising from segment I (below the renal vessels) of the inferior vena cava. She was successfully managed with radical surgical excision and reconstruction of the inferior vena cava with synthetic graft.
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Affiliation(s)
- Santosh Kumar
- Department of Urology, Postgraduate Institute of Medical Education and Research, India
| | - Sudheer Kumar Devana
- Department of Urology, Postgraduate Institute of Medical Education and Research, India
| | - Sachin Kuthe
- Department of Urology, Postgraduate Institute of Medical Education and Research, India
| | - Thakur Deen Yadav
- Department of Urology, Postgraduate Institute of Medical Education and Research, India
| | - Seema Prasad
- Department of Urology, Postgraduate Institute of Medical Education and Research, India
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38
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Mahmoud M, Messaoud M, Riahi H, Azaiz O. Solution to Case 2. Leiomyosarcoma of the inferior vena cava revealed by lower extremities edema. ANGIOLOGIA 2014. [DOI: 10.1016/j.angio.2014.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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39
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Goto H, Hashimoto M, Akamatsu D, Shimizu T, Miyama N, Tsuchida K, Tajima Y, Ohuchi N. Surgical resection and inferior vena cava reconstruction for treatment of the malignant tumor: technical success and outcomes. Ann Vasc Dis 2014; 7:120-6. [PMID: 24995055 DOI: 10.3400/avd.oa.13-00125] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/29/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The purpose of this study was to review patients who underwent inferior vena cava (IVC) resection with concomitant malignant tumor resection and to consider the operative procedures and the outcomes. MATERIALS AND METHODS Between 2000 and 2012, 41 patients underwent resection of malignant tumors concomitant with surgical resection of the IVC at our institute. The records of these patients were retrospectively reviewed. RESULTS Primary tumor resections included nephrectomy, hepatectomy, retroperitoneal tumor extirpation, lymph node dissection, and pancreaticoduodenectomy. The IVC interventions were partial resection in 23 patients and total resection in 18 patients. Four patients underwent IVC replacement. Operation-related complications included pulmonary embolism, acute myocardial infarction, deep vein thrombosis, leg edema and temporary hemodialysis. There were no operative deaths. The mean follow-up period was 24.9 months (range: 2-98 months). The prognosis depended on the type and stage of the tumor. CONCLUSION Resection and reconstruction of the IVC can be performed safely if the preoperative evaluations and surgical procedures are performed properly. The IVC resection without reconstruction was permissive if the IVC was completely obstructed preoperatively, but it may also be considered in cases where the IVC is not completely obstructed.
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Affiliation(s)
- Hitoshi Goto
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Munetaka Hashimoto
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Daijiro Akamatsu
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Takuya Shimizu
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Noriyuki Miyama
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Ken Tsuchida
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Yuta Tajima
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Noriaki Ohuchi
- Division of Advanced Surgical Science and Technology, Tohoku University Hospital, Sendai, Miyagi, Japan
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40
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Lee HM, Jeong DS, Park PW, Kim WS, Sung K, Lee YT. Surgical treatment for an invasive leiomyosarcoma of the inferior vena cava. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2013; 46:373-6. [PMID: 24175275 PMCID: PMC3810562 DOI: 10.5090/kjtcs.2013.46.5.373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/12/2013] [Accepted: 05/20/2013] [Indexed: 11/16/2022]
Abstract
A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.
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Affiliation(s)
- Hee Moon Lee
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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41
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Beardo P, José Ledo M, Jose Luis RC. Renal leiomyosarcoma. Rare Tumors 2013; 5:e42. [PMID: 24179654 PMCID: PMC3804817 DOI: 10.4081/rt.2013.e42] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 11/23/2022] Open
Abstract
Leiomyosarcoma (LMS) is a rare malignant tumor of smooth muscle origin that generally stems from soft tissues and uterine tissue. Although, a small percentage of these may originate from the smooth muscle or vessel walls, most of which are of venous origin. Renal leiomyosarcomas may arise from the smooth muscle fibers of renal pelvis, renal capsule or renal vessels, last one is the most frequent. We report a case of renal LMS that could be originated in the renal capsule.
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Affiliation(s)
- Pastora Beardo
- Department of Urology, Hospital de Jerez, Cádiz University
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42
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Zhang Y, Zhu J, Wang C, Tu R, Jiang J, Lu W. Multimodality treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity. Expert Rev Anticancer Ther 2013; 13:137-41. [PMID: 23406554 DOI: 10.1586/era.12.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Difficulties in the preoperative preparation and surgical management of patients with intravenous leiomyomatosis involving the heart and pulmonary artery resulting in intracardiac leiomyomatosis necessitate further investigation of this condition. In this report, we describe the interdisciplinary treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity. A single-stage surgical procedure with a combined thoracic and abdominal approach was performed in both cases and the tumors were successfully excised. The procedure also involved removal of the atrial, caval and other venular extensions, and total hysterectomy with bilateral salpingo-oophorectomy. Postoperative pathology findings confirmed the diagnosis of intravenous leiomyomatosis. Neither patient died perioperatively, and no complications were observed.
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Affiliation(s)
- Yong Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, Shanghai, China
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43
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Acute Fulminant Form of Budd–Chiari Syndrome Secondary to Inferior Vena Cava Sarcoma: a Case Report and Review of the Literature. J Gastrointest Cancer 2013; 44:472-6. [DOI: 10.1007/s12029-012-9475-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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44
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Padilla-Fernandez B, Lorenzo-Gomez MF, Herrero-Polo M, Silva-Abuin JM, Martin-Izquierdo M, Antunez-Plaza P. Leiomyosarcoma of the inferior vena cava in a patient with double inferior vena cava. Ann Vasc Surg 2012; 26:859.e1-5. [PMID: 22717359 DOI: 10.1016/j.avsg.2011.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 07/03/2011] [Accepted: 11/04/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor arising from its smooth muscle cells. METHODS AND RESULTS We report the case of a 38-year-old woman presenting with back pain and weight loss who was diagnosed with a 22-cm leiomyosarcoma of the right IVC and thrombosis of the left IVC. The patient is alive and free of recurrence a year after radical tumor resection with removal of the affected IVC, reconstruction with polytetrafluoroethylene prosthetic graft, and anastomosis of both right and left IVC. CONCLUSIONS Leiomyosarcoma is a rare and aggressive tumor with a deceitful course. Radical surgical en bloc resection is the mainstay of treatment for IVC leiomyosarcomas. For an adequate restoration of venous return, complex vascular repair may be necessary.
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45
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Vladov NN, Mihaylov VI, Belev NV, Mutafchiiski VM, Takorov IR, Sergeev SK, Odisseeva EH. Resection and reconstruction of the inferior vena cava for neoplasms. World J Gastrointest Surg 2012; 4:96-101. [PMID: 22590663 PMCID: PMC3351494 DOI: 10.4240/wjgs.v4.i4.96] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 02/27/2012] [Accepted: 03/10/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the results of an aggressive surgical approach of resection and reconstruction of the inferior vena cava (IVC).
METHODS: The approach to caval resection depends on the extent and location of tumor involvement. The supra- and infra-hepatic portion of the IVC was dissected and taped. Left and right renal veins were also taped to control the bleeding. In 12 of the cases with partial tangential resection of the IVC, the flow was reduced to less than 40% so that the vein was primarily closed with a running suture. In 3 of the cases, the lumen of the vein was significantly reduced, requiring the use of a polytetrafluoroethylene (PTFE) patch. In 2 of the cases with segmental resection of the IVC, a PTFE prosthesis was used and in 1 case, the IVC was resected without reconstruction due to shunting the blood through the azygos and hemiazygos veins.
RESULTS: The mean operation time was 266 min (230-310 min) with an average intraoperative blood loss of 300 mL (200-2000 mL). The patients stayed in intensive care unit for 1.8 d (1-3 d). Mean hospital stay was 9 d (7-15 d). Twelve patients (66.7%) had no complications and 6 patients (33.3%) had the following complications: acute bleeding in 2 patients; bile leak in 2 patients; intra abdominal abscess in 1 patient; pulmonary embolism in 2 patients; and partial thrombosis of the patch in 1 patient. General complications such as pneumonia, pleural effusion and cardiac arrest were observed in the same group of patients. In all but 1 case, the complications were transient and successfully controlled. The mortality rate was 11.1% (n = 2). One patient died due to cardiac arrest and pulmonary embolism in the operation room and the second one died 2 d after surgery due to coagulopathy. With a median follow-up of 24 mo, 5 (27.8%) patients died of tumor recurrence and 11 (61.1%) are still alive, but three of them have a recurrence on computed tomography.
CONCLUSION: There are a variety of options for reconstruction after resection of the IVC that offers a higher resectable rate and better prognosis in selected cases.
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Affiliation(s)
- Nikola Nikolov Vladov
- Nikola Nikolov Vladov, Vassil Ivanov Mihaylov, Nikolai Vassilev Belev, Ventzislav Metodiev Mutafchiiski, Ivelin Rumenov Takorov, Sergei Kirilov Sergeev, Evelina Hristova Odisseeva, Hepato-biliary, Pancreatic and Transplant Surgery, Military Medical Academy, Sofia 1606, Bulgaria
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46
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Quinones-Baldrich W, Alktaifi A, Eilber F, Eilber F. Inferior vena cava resection and reconstruction for retroperitoneal tumor excision. J Vasc Surg 2012; 55:1386-93; discussion 1393. [PMID: 22386140 DOI: 10.1016/j.jvs.2011.11.054] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/09/2011] [Accepted: 11/09/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study reviews the results of en bloc resection of the inferior vena cava (IVC) for malignant tumor excision and reconstruction. METHODS A prospective database was reviewed. IVC resection was categorized as suprarenal, perirenal, infrarenal, or extensive (>one segment resected). Repairs were divided into primary, patch, or circumferential. Tumor type, perioperative morbidity, mortality, and graft patency were recorded. RESULTS Between 1990 and 2011, 47 patients (21 women; mean age, 56; range, 35-89 years) underwent IVC resection for en bloc tumor excision. Sarcomas were most common (36 [77%]: 30 primary IVC). Eleven patients had primary IVC repair, nine patch repair (two autogenous), and 27 had circumferential replacement with a polytetrafluoroethylene ringed graft. Extensive IVC reconstruction in 18 patients included the entire IVC, with renal (RV) and hepatic vein reimplantation in eight; suprarenal and perirenal in six (seven RVs reimplanted); and infrarenal and perirenal in four (four RVs reimplanted). Nine single-segment IVC replacements were infrarenal. Morbidity was 10.6%: one each with bowel obstruction, chyle leak, renal failure with complete recovery (left RV reimplant, right nephrectomy), reoperation for bleeding, and IVC graft thrombosis. Morbidity did not differ by type of reconstruction. There was no mortality. Follow-up ranged from 1.5 to 216 months (18 years) with a mean of 3.5 years. Computed tomography or duplex scans were available in 28 of 47 patients and in 15 of 27 patients in group 3 at a mean follow-up of 36 and 20 months, respectively. One IVC graft thrombosis was documented at 10 months after chemotherapy/sepsis. Tumor recurrence caused three graft stenoses. Cumulative 5-year patency in group 3 was 80% (imaging) and 92% (clinical). Lower extremity edema was universally avoided. Cumulative 5-year survival for the series was 45% ± 8.5%. Mean long-term survival was 5.8 ± 0.56 years (range, 4 months-17 years), with a significant difference between primary or patch (mean, 6.5 years) and circumferential or extensive repair (mean, 4.2 years; P < .005). Cumulative (47% vs 52%) and mean (3.1 vs 3.6 years; P > .12) survival was similar between patients with single-segment and extensive IVC resection and replacement. CONCLUSIONS IVC resection and reconstruction for en bloc tumor excision is safe, even when extensive repairs are necessary. Replacement of the IVC with prosthetic graft avoids extremity venous complications and likely contributes to quality of survival. Survival depends on tumor behavior and degree of IVC involvement, where primary and patch repair has a better prognosis than circumferential resection.
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47
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Early diagnosis and resection of an asymptomatic leiomyosarcoma of the inferior vena cava prior to caval obstruction. J Vasc Surg 2012; 55:525-8. [DOI: 10.1016/j.jvs.2011.06.112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/20/2011] [Accepted: 06/25/2011] [Indexed: 11/24/2022]
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Mu D, Wang D, Zhou K, Zhu B. Radiographic features of intraluminal leiomyosarcoma of the inferior vena cava: an atypical case report. ACTA ACUST UNITED AC 2012; 36:586-9. [PMID: 21212948 DOI: 10.1007/s00261-010-9673-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We encountered a 74-year-old woman with a chief complaint of progressive right-sided back pain for more than 1 month. Physical examination and laboratory tests revealed no abnormalities. Multislice computed tomography (MSCT) showed dilatation of the inferior vena cava (IVC). An intraluminal mass of about 8.1 × 5.5 × 3.6 cm in size was found in the IVC, with big central necrosis and irregular peripheral enhancement. The tumor arose from the IVC just beneath the renal vein and reached the iliac bifurcation. Cavography demonstrated a filling defect with complete occlusion of the IVC and extensive collateral circulation. The patient underwent complete resection of tumor and vascular prosthetic graft. Pathological diagnosis was leiomyosarcoma. Because of its low incidences and atypical appearance, we highlight the significance of the imaging feature in its diagnosis in this article.
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Affiliation(s)
- Dan Mu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
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49
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Mullinax JE, Zager JS, Gonzalez RJ. Current diagnosis and management of retroperitoneal sarcoma. Cancer Control 2011; 18:177-87. [PMID: 21666580 DOI: 10.1177/107327481101800305] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Retroperitoneal sarcomas are rare neoplasms that often present with multivisceral involvement. Treatment for these tumors requires careful decision making requiring a combination of surgery, chemotherapy, and radiation therapy. METHODS We reviewed the scientific literature pertaining to the diagnosis and management of retroperitoneal sarcomas. We also identify recent developments in treatment and discuss future trends in the care of patients with this disease. RESULTS Retroperitoneal tumors often present as large, locally advanced lesions. Evaluation of these tumors requires careful consideration of a multimodality approach. Retrospective data and historical prospective series have demonstrated the survival benefit of radical resection for these tumors with en bloc resection of involved structures. Compartmental resections in the retroperitoneum along with debulking of high-grade disease and regional therapy are controversial approaches with significant morbidity that can lead to long-term survival. The application of neoadjuvant and adjuvant therapies in select tumor histologies may improve local control and survival. CONCLUSIONS The management of retroperitoneal sarcomas requires a multidisciplinary approach and is best accomplished at high-volume centers specializing in the care of patients with these complex malignancies. Current data suggest that radical resection remains the only chance for cure and that chemotherapy and radiation therapy may confer a survival benefit.
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Affiliation(s)
- John E Mullinax
- Department of Surgery at The University of South Florida College of Medicine, Tampa, Florida, USA
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50
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Fahrig C, Heidrich H. Leiomyosarcoma of the common femoral and external iliac veins. Int J Angiol 2011. [DOI: 10.1007/bf01616827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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