Ressecção cirúrgica de leiomiossarcoma de veia cava inferior retro-hepática sem reconstrução vascular: relato de caso
Surgical resection of retrohepatic inferior vena cava leiomyosarcoma without vascular reconstruction: case report
Ian Freire Castro; Paulo Henrique Silva Nunes; Ana Camila Xavier Lopes; Mariana Coelho Lima; Régis Ponte Conrado; Renato Mazon Lima Verde Leal; Annya Costa Araújo de Macedo Goes; Marcelo Leite Vieira Costa
Resumo
Palavras-chave
Abstract
Inferior vena cava leiomyosarcoma (IVCL) is a rare malignant mesenchymal tumor. Surgical treatment is a challenge because it must combine free surgical margins with vascular reconstruction, using prosthetic or autologous grafts, primary suture, or simple ligation without vein reconstruction. The ligation option is possible thanks to the slow growth of the tumor, allowing collateral venous circulation to develop. We present a case of an IVCL treated with radical resection without vascular reconstruction. The patient was a 48-year-old female with abdominal pain in the right upper quadrant, asthenia, and postprandial dyspeptic symptoms. Abdominal tomography revealed a mass with an expansive formation located in the infrahepatic segment of the inferior vena cava and reduced vessel lumen. During surgery, vein clamping did not provoke hemodynamic repercussions, suggesting sufficient collateral circulation formation. It was decided to perform a radical resection of the entire portion of the retrohepatic vena cava and ligate the vena cava without vascular reconstruction. The patient recovered without complications.
Keywords
References
1 Rusu CB, Gorbatâi L, Szatmari L, et al. Leiomyosarcoma of the inferior vena cava. Our experience and a review of the literature. Rom J Morphol Embryol. 2020;61(1):227-33.
2 Gaignard E, Bergeat D, Robin F, Corbière L, Rayar M, Meunier B. Inferior vena cava leiomyosarcoma: what method of reconstruction for which type of resection? World J Surg. 2020;44(10):3537-44.
3 Hardwigsen J, Balandraud P, Ananian P, Saïsse J, Treut YP. Leiomyosarcoma of the retrohepatic portion of the inferior vena cava: clinical presentation and surgical management in five patients. J Am Coll Surg. 2005;200(1):57-63.
4 Drukker L, Alberton J, Reissman P. Leiomyosarcoma of the inferior vena cava: radical surgery without vascular reconstruction. Vasc Endovascular Surg. 2012;46(8):688-90.
5 Puerta A, Vilar JA, Núñez J, Hervás PL, Nuño J. Leiomyosarcoma of the inferior vena cava. Cir Esp. 2020;98(4):243-5.
6 Mingoli A, Cavallaro A, Sapienza P, 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(5B):3201-5. PMid:8920790.
7 Wang MX, Menias CO, Elsherif SB, Segaran N, Ganeshan D. Current update on IVC leiomyosarcoma. Abdom Radiol. 2021;46(11):5284-96.
8 Mingoli A, Sapienza P, Cavallaro A, et al. The effect of extend of caval resection in the treatment of inferior vena cava leiomyosarcoma. Anticancer Res. 1997;17(5B):3877-81. PMid:9427796.
9 Joung HS, Nooromid MJ, Eskandari MK, Wayne JD. Surgical approach, management, and oncologic outcomes of primary leiomyosarcoma of the inferior vena cava: an institutional case series. J Surg Oncol. 2020;122(7):1348-55.
10 Nabati M, Azizi S. Leiomyosarcoma of the inferior vena cava presenting as a cardiac mass. J Clin Ultrasound. 2018;46(6):430-3.
11 Cho SW, Marsh JW, Geller DA, et al. Surgical management of leiomyosarcoma of the inferior vena cava. J Gastrointest Surg. 2008;12(12):2141-8.
12 Jiang H, Wang YX, Li B, et al. Surgical management of leiomyosarcoma of the inferior vena cava. Vascular. 2015;23(3):329-32.
13 Daylami R, Amiri A, Goldsmith B, Troppmann C, Schneider PD, Khatri VP. Inferior vena cava leiomyosarcoma: is reconstruction necessary after resection? J Am Coll Surg. 2010;210(2):185-90.
14 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(4):575-9.
Submitted date:
08/10/2022
Accepted date:
10/31/2022
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email