Complete surgical resection of progressive retroperitoneal leiomyosarcoma with inferior vena cava tumor thrombus and liver metastasis can achieve short-term disease control and survival.
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Supports feasibility of complete resection in advanced adrenocortical carcinoma with IVC thrombus; leaves open optimal patient selection and outcomes.
We present a case in a 74-year-old female patient whose initial symptom was right flank pain. Enhanced computed tomography showed a mass (about 15×12 cm) in the retroperitoneum, inferior vena cava tumor thrombus (Level III: Neves and Zincke system) and liver metastasis. The primary tumor exploded and inferior vena cava tumor thrombus caused congestive liver one and a half month later. Preoperative diagnosis was right adrenocortical carcinoma (cT4N0M1 stage IV). We performed complete resection of tumor including metastasis. Pathological findings on the resected specimen revealed pleomorphic leiomyosarcoma, which was discontinuous tumor from the right normal adrenal grand. There was no evidence of local recurrence or metastasis after 6 months with no additional treatment.
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Kujime et al. (2020) studied this question.
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