A case of resected leiomyosarcoma of the inferior vena cava.

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  • 下大静脈原発平滑筋肉腫の１例

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Abstract

A 72-year-old man was seen at the hospital because of right upper abdominal pain during urination. Ultrasonography and a CT scan revealed a right upper abdominal tumor and the patient was admitted to the department. On a physical examination, a fist-sized and tender tumor was palpable beneath the right hypochondrium. CT scan visualized an irregular shaped and enhanced tumor at a 7cm liver margin in the vicinity of the aorta in subhepatic space. Magnetic resonance imaging revealed a low signal intensity comparable to that of muscular tissue. Angiography revealed accumulation of a contrast material in the subhepatic space. Inferior venography revealed complete obstruction at influxion of the renal vein. With a suspicion of leiomyosarcoma primary arising in the inferior vena cava, the patient was operated on. Operative procedures included a partial resection of the inferior vena cava including the tumor, a partial resection of caudate lobe in the posterior segment of liver, a partial duodenectomy, and associated resection of the right kidney. Since collateral circulation was kept, no reconstruction of the inferior vena cava was made. Histologically, the tumor was leiomyosarcoma of the inferior vena cava invading the liver, duodenum and right kidney. Postoperative course was uneventful, but intraabdominal recurrence occurred three months after the operation. The patient died six months after the operation.

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