Successful Resection of Leiomyosarcoma Originating from the Inferior Vena Cava with Common Iliac Artery and Vein Reconstruction: A Case Report.

Abstract

Introduction: Leiomyosarcomas originating from the inferior vena cava are extremely rare. Because they have a strong tendency to invade the surrounding vital structures, cure can only be achieved by R0 resection.

Case presentation: A 59-year-old Japanese woman was referred to our hospital because an abdominal tumor had been detected on a routine ultrasound examination. Computed tomography revealed a 7.0 × 5.3 cm lesion occluding the inferior vena cava to the confluence of the common iliac vein and creating a mass effect on the adjacent aorta and common iliac artery bifurcation. After an open biopsy had yielded a diagnosis of leiomyosarcoma, radical surgery was planned. The tumor was excised en bloc together with the inferior vena cava and abdominal aorta and reconstruction performed using artificial blood vessels. Histopathological examination of the resected specimen confirmed it was a leiomyosarcoma originating from the inferior vena cava and invading the aorta and that the surgical margins were negative.

Conclusions: This report of a rare case of a leiomyosarcoma originating from the inferior vena cava and invading the aorta emphasizes that this combination of pathologies does not preclude curative surgery. However, more data are needed. Further research on leiomyosarcomas is essential for optimizing management and prognosis.