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

Kazuhiko Shimamura, Toshiyuki Yamazaki, Shiro Kuwabara, Norio Katayanagi, Mutsuo Yamamoto and Hideki Saito

Department of Surgery, Niigata City General Hospital

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 10 cm 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 19×14×12 cm 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.

Key words
retroperitoneal tumor, leiomyosarcoma, inferior vena cava

Reprint requests
Kazuhiko Shimamura Division of Digestive and General Surgery, Department of Surgery, Niigata University
1-757 Asahimachidori, Niigata, 951-8510 JAPAN

Accepted
September 28, 2005

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