Leiomyosarcoma of the Inferior Vena Cava: Diagnosis and Surgical Management

doi:10.1001/archsurg.1976.01360280039006

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Vol. 111 No. 10, October 1976

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Leiomyosarcoma of the Inferior Vena Cava

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 arisingmost frequently from the inferior vena cava (IVC). We reporton three patients one of whom underwent definitive resection.These tumors most commonly involve the upper segment of theIVC, 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 causeright-sided pain. Diagnosis is difficult, but is best approachedpreoperatively by angiography and vena cavography. Optimal therapyof lesions at these levels is surgical resection. Resectionof the IVC below the hepatic veins is possible with renal functionpreserved 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 (DrBrewster).

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