Key result
Complete R0 resection of inferior vena cava leiomyosarcoma achieves 5-year recurrence-free survival.
Case Report (n=1)
No
Complete surgical resection is a viable and important management strategy for leiomyosarcoma of the IVC, especially given the low efficacy of adjuvant chemotherapy.
Answers are grounded in this paper and cite their sources.
May support R0 resection in select IVC leiomyosarcoma; hypothesis-generating given Level 5 evidence.
A 76-year-old Japanese man was referred to our hospital with chief complaint of right hypochondoralgia. Abdominal ultrasound showed a retroperitoneal tumor in the suprarenal region of the right kidney. Computed tomography revealed an enhanced lobular tumor with irregular, circumscribed, and indistinct border. Ultrasound-guided biopsy was performed. The tumor consisted of spindle-shaped cells with a giant nucleus and multinuclear cells. The diagnosis was leiomyosarcoma by immunohistochemical staining. The patient underwent surgery accessed by a right eighth intercostal thoracoabdominal incision. The tumor was completely resected, accompanied by removal of the posterosuperior segment of the right hepatic lobe, right adrenal gland, and a portion of the inferior vena cava (IVC). The histopathologic diagnosis was leiomyosarcoma arising from the IVC. We present a rare case of a successfully managed leiomyosarcoma of the IVC. This case suggests the importance of curative surgical resection of the tumor due to low efficacy of adjuvant chemotherapy for leiomyosarcoma.
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Sonoda et al. (2015) conducted a case report in Primary vascular leiomyosarcoma arising from the inferior vena cava (n=1). Complete en bloc surgical resection (R0) including the posterosuperior segment of the right hepatic lobe, right adrenal gland, and part of the inferior vena cava was evaluated on Recurrence-free survival at 5 years. Complete en bloc surgical resection (R0) of a 50 × 45 × 40 mm inferior vena cava leiomyosarcoma resulted in an uneventful postoperative discharge on day 18 and 5-year recurrence-free survival.
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