Ann Hepatobiliary Pancreat Surg.  2019 Aug;23(3):274-277. 10.14701/ahbps.2019.23.3.274.

Inferior vena cava leiomyosarcoma in an octogenerian

• Madhavan S
• Junnarkar
• Koh NW
• Shelat VG

• KMID: 2456026
• DOI: http://doi.org/10.14701/ahbps.2019.23.3.274

Abstract

Inferior Vena Cava (IVC) leiomyosarcoma (LM) is a rare malignancy of mesenchymal origin with an incidence of 1/100,000. We present an 82-year-old lady with a past history of open cholecystectomy who presented with a large indeterminate mass on abdominal imaging. Open resection of the mass was performed and histology with immunohistochemical staining revealed leiomyosarcoma. She received adjuvant radiotherapy and remained disease free 4 years after.

Keyword

Inferior vena cava; Leiomyosarcoma; Octogenerian; Sarcoma; Vascular tumour

MeSH Terms

Aged, 80 and over
Cholecystectomy
Humans
Incidence
Leiomyosarcoma*
Radiotherapy, Adjuvant
Sarcoma
Vena Cava, Inferior*

Figure

• 

  Fig. 1 Preoperative computed tomography of the abdomen and pelvis. Computed tomography scan showing mass with internal calcification which abuts inferior vena cava and is within the gallbladder bed.

• 

  Fig. 2 Histopathological specimens of the tumor. (A) Macroscopic photos of resection specimen showing the characteristic fleshy appearance of a mesenchymal tumor. (B) intersecting fascicles of eosinophilic tumor cells (Haematoxylin and eosin stain ×50). (C) Areas show marked nuclear atypia with mitoses (Haematoxylin and eosin ×200). (D) The tumor cells show strong desmin positivity (Desmin stain ×200).

Reference

1. Kwon TW, Sung KB, Cho YP, Kim DK, Yang SM, Ro JY, et al. Pararenal leiomyosarcoma of the inferior vena cava. J Korean Med Sci. 2003; 18:355–359. PMID: 12808321.

2. Hollenbeck ST, Grobmyer SR, Kent KC, Brennan MF. Surgical treatment and outcomes of patients with primary inferior vena cava leiomyosarcoma. J Am Coll Surg. 2003; 197:575–579. PMID: 14522326.

3. Laskin WB, Fanburg-Smith JC, Burke AP, Kraszewska E, Fetsch JF, Miettinen M. Leiomyosarcoma of the inferior vena cava: clinicopathologic study of 40 cases. Am J Surg Pathol. 2010; 34:873–881. PMID: 20463568.

4. Mingoli A, Cavallaro A, Sapienza P, Di Marzo L, Feldhaus RJ, Cavallari N. International registry of inferior vena cava leiomyosarcoma: analysis of a world series on 218 patients. Anticancer Res. 1996; 16:3201–3205. PMID: 8920790.

5. Wachtel H, Gupta M, Bartlett EK, Jackson BM, Kelz RR, Karakousis GC, et al. Outcomes after resection of leiomyosarcomas of the inferior vena cava: a pooled data analysis of 377 cases. Surg Oncol. 2015; 24:21–27. PMID: 25433957.

6. Spinelli A, Schumacher G, Benckert C, Sauer IM, Schmeding M, Glanemann M, et al. Surgical treatment of a leiomyosarcoma of the inferior vena cava involving the hepatic and renal veins confluences: technical aspects. Eur J Surg Oncol. 2008; 34:831–835. PMID: 17321715.

7. Kevorkian J, Cento DP. Leiomyosarcoma of large arteries and veins. Surgery. 1973; 73:390–400. PMID: 4687797.

8. Kulaylat MN, Karakousis CP, Doerr RJ, Karamanoukian HL, O'Brien J, Peer R. Leiomyosarcoma of the inferior vena cava: a clinicopathologic review and report of three cases. J Surg Oncol. 1997; 65:205–217. PMID: 9236931.

9. Dzsinich C, Gloviczki P, van Heerden JA, Nagorney DM, Pairolero PC, Johnson CM, et al. Primary venous leiomyosarcoma: a rare but lethal disease. J Vasc Surg. 1992; 15:595–603. PMID: 1560548.

10. Liu C, Zheng Y, Yang X, Shao J, Song X, Liu B, et al. Surgical resection of the inferior vena cava for leiomyosarcoma. Ann Vasc Surg. 2010; 24:822.e11–822.e15.

11. Mingoli A, Feldhaus RJ, Cavallaro A, Stipa S. Leiomyosarcoma of the inferior vena cava: analysis and search of world literature on 141 patients and report of three new cases. J Vasc Surg. 1991; 14:688–699. PMID: 1942380.

12. Monteagudo Cortecero J, Guirau Rubio MD, Payá Romá A. Leiomyosarcoma of the inferior vena cava: AIRP best cases in radiologic-pathologic correlation. Radiographics. 2015; 35:616–620. PMID: 25763742.

13. Alkhalili E, Greenbaum A, Langsfeld M, Marek J, Rana MA, Glew R, et al. Leiomyosarcoma of the inferior vena cava: a case series and review of the literature. Ann Vasc Surg. 2016; 33:245–251. PMID: 26802297.

14. Hines OJ, Nelson S, Quinones-Baldrich WJ, Eilber FR. Leiomyosarcoma of the inferior vena cava: prognosis and comparison with leiomyosarcoma of other anatomic sites. Cancer. 1999; 85:1077–1083. PMID: 10091791.

15. Teixeira FJR Jr, do Couto Netto SD, Perina ALF, Torricelli FCM, Ragazzo Teixeira L, Zerati AE, et al. Leiomyosarcoma of the inferior vena cava: survival rate following radical resection. Oncol Lett. 2017; 14:3909–3916. PMID: 29098019.

16. Ito H, Hornick JL, Bertagnolli MM, George S, Morgan JA, Baldini EH, et al. Leiomyosarcoma of the inferior vena cava: survival after aggressive management. Ann Surg Oncol. 2007; 14:3534–3541. PMID: 17896156.