J Korean Surg Soc.  2010 May;78(5):330-333. 10.4174/jkss.2010.78.5.330.

Leiomyosarcoma of the Inferior Vena Cava Mimicking Right Adrenal Tumor

• Lee JR
• Shin HM
• Choi SJ

• KMID: 2211961
• DOI: http://doi.org/10.4174/jkss.2010.78.5.330

Abstract

The most frequent tumor arising from retroperitoneum is sarcoma. Most sarcomas of retroperitoneal origin have no symptoms and comprise 15% of all sarcomas. However, they can grow so great as to cause pain, which implies the possibility of invasion to adjacent organs. Moreover, if its location is between right adrenal gland and inferior vena cava (IVC) ambiguity of its origin can arise. Leiomyosarcoma of IVC is so rare that it can be seen to mimic right adrenal tumor. This 56-year-old female patient with back pain since approximately 4 months prior was transferred to our hospital via local clinic. We performed radical resection of tumor including segmental resection of IVC. Final diagnosis was leiomyosarcoma of IVC. We report this case with a review of literature.

Keyword

Leiomyosarcoma; Inferior vena cava

MeSH Terms

Adrenal Glands
Back Pain
Female
Humans
Hydrazines
Leiomyosarcoma
Middle Aged
Sarcoma
Vena Cava, Inferior
Hydrazines

Figure

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  Fig. 1 Abdominal CT shows a large lobulated mass with partial invasion of inferior vena cava (IVC) and heterogeneous delayed enhancement between IVC and right adrenal gland.

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  Fig. 2 Intra-operative finding shows cannulated inferior vena cava (IVC) between Infrahepatic portion and just above portion of renal vein with vascular tourniquets, which the tumor about 7 cm in diameter surrounds from the right side of IVC to adjacent to right adrenal gland.

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  Fig. 3 (A) Cut surface of specimen shows grayish and hard shape with mucoid change and necrosis. (B) The slide shows intravascular proliferation of atypical spindle cells (H&E stain, ×100). (C) The slide shows leiomyosarcoma showing many atypical mitoses and nuclear anaplasia (H&E stain, ×400).

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