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Diagnosis and Surgical Management

David C. Brewster, MD; Cristos A. Athanasoulis, MD; R. Clement Darling, MD

Arch Surg. 1976;111(10):1081-1085.

Abstract
• Leiomyosarcoma of vascular origin are rare tumors arising most frequently from the inferior vena cava (IVC). We report on three patients one of whom underwent definitive resection. These tumors most commonly involve the upper segment of the IVC, and appear with manifestations of the Budd-Chiari syndrome. Lesions at this level are not amenable to surgical therapy. Tumors of the middle and lower segments of the IVC usually cause right-sided pain. Diagnosis is difficult, but is best approached preoperatively by angiography and vena cavography. Optimal therapy of lesions at these levels is surgical resection. Resection of the IVC below the hepatic veins is possible with renal function preserved by collateral drainage of the left renal vein.

(Arch Surg 111:1081-1085, 1976)

Author Affiliations
From the General Surgical Services (Drs Brewster and Darling) and Department of Radiology (Dr Athanasoulis), Massachusetts General Hospital, and the departments of surgery and radiology, Harvard Medical School, Boston.

Footnotes
Accepted for publication May 18, 1976.

Reprint requests to 3 Hawthorne Place, Boston, MA 02114 (Dr Brewster).

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