下大静脈合併切除を要した巨大後腹膜平滑筋肉腫の１切除例

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  • A Resected Case Report of Retroperitoneal Leiomyosarcoma Invading the Inferior Vena Cava

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A 44-year-old man with upper abdominal pain and a retroperitoneal tumor detected by abdominal CT was found to have a large tumor palpable in the upper right abdomen, but no abdominal tenderness or peritoneal irritation. Abdominal CT showed a large tumor adjacent to the lower hepatic surface. Portography showed a tumor-compressed portal vein without invasion of the portal vein. Inferior vena cavography showed invasion of the inferior vena cava above the orifice of the right renal vein. The preoperative diagnosis was a retroperitoneal tumor. Laparotomy showed that the tumor stretched from the upper right renal vein and right adrenal gland to the lower hepatic surface with invasion to 10cm into the inferior vena cava. The tumor was extirpated in wedge resection of the inferior vena cava. The defect of the inferior vena cava was repaired by a continuous suture. The resected tumor was 19×14×12cm and histologically diagnosed as leiomyosarcoma. Only surgical removal effectively treats leiomyosarcoma. Especially in retroperitoneal leiomyosarcoma, tumor invasion to major vessels is proved by diagnostic imaging. Tumor recurrence should be diagnosed and treated early by diagnostic imaging.

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