Key result
Radical nephrectomy and IVC thrombectomy for primary renal leiomyosarcoma yields 7-month survival before fatal metastases.
Case Report (n=1)
Renal leiomyosarcoma can invade the inferior vena cava similarly to renal cell carcinoma, requiring consideration in differential diagnosis.
Alerts clinicians to rare leiomyosarcoma in renal masses with IVC thrombus; leaves open standardized management approaches.
INTRODUCTION: We report a rare case of primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava. CASE PRESENTATION: A 54-year-old woman presented with right flank pain and abdominal distension. Physical examination findings were unremarkable. Abdominal computed tomography revealed a heterogeneously enhancing right solid renal mass with a thrombus in the renal vein extending into the inferior vena cava. Magnetic resonance imaging demonstrated a renal tumor with a thrombus about 4 cm below the hepatic vein. Chest computed tomography and bone scintigraphy were negative. The patient underwent right radical nephrectomy and vena cava thrombectomy. Histophathologic evaluation of the resected tumor confirmed the diagnosis of leiomyosarcoma. She underwent no adjuvant therapy. Seven months after surgery, the patient died following a 2-month history of multiple pulmonary and hepatic metastases. CONCLUSION: This report highlights the importance of considering the possibility of renal leiomyosarcoma invasion to the inferior vena cava, similar to renal cell carcinoma.
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Konno et al. (2021) conducted a case report in Primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava (n=1). Right radical nephrectomy and vena cava thrombectomy was evaluated on Clinical outcome. A 54-year-old woman with primary renal leiomyosarcoma and an inferior vena cava tumor thrombus died 7 months after right radical nephrectomy and thrombectomy due to multiple metastases.
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