Leiomyosarcoma of the inferior vena cava. Diagnosis and surgical management
D. C. Brewster, C. A. Athanasoulis and R. C. Darling
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.
