Key result
Neoadjuvant chemoradiation enables complete IVC leiomyosarcoma resection without cardiopulmonary bypass.
Why the study?
Leiomyosarcomas of the inferior vena cava with venous extension to the right atrium are rare and pose unique surgical challenges requiring multidisciplinary approaches.
Case Report (n=1)
This case demonstrates the feasibility of en-bloc surgical resection without cardiopulmonary bypass for extensive IVC leiomyosarcoma with right atrial extension.
May support bypass avoidance in select extensive IVC leiomyosarcoma; single-case data leaves generalizability and safety open.
Background Leiomyosarcomas (LMS) of the inferior vena cava (IVC) are a rare form of retroperitoneal malignancy and their venous extension to the right atrium is an even rarer event. These tumors pose a unique surgical challenge and often require a multidisciplinary team-based approach for their surgical treatment. Case presentation: We present a case of a 68-year-old male with primary LMS of the IVC with a tumor thrombus extending into the right atrium that was initially deemed inoperable. Conclusions After extensive neoadjuvant chemo-radiation with minimal tumor effect, the patient underwent en-bloc surgical resection of the tumor along with removal of the infrarenal IVC and right kidney and adrenal without the need for cardiopulmonary bypass.
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Castellanos et al. (2023) conducted a case report in Leiomyosarcoma of the inferior vena cava with right atrium tumor thrombus (n=1). En-bloc surgical resection without cardiopulmonary bypass following neoadjuvant chemoradiation was evaluated on Surgical success and patient survival. En-bloc surgical resection of an initially inoperable inferior vena cava leiomyosarcoma with right atrium tumor thrombus was successfully achieved without cardiopulmonary bypass after neoadjuvant chemoradiation.
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