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Surgical resection of retrohepatic inferior vena cava leiomyosarcoma without vascular reconstruction: case report

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 lig...

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Detalles Bibliográficos
Autores principales: Castro, Ian Freire, Nunes, Paulo Henrique Silva, Lopes, Ana Camila Xavier, Lima, Mariana Coelho, Conrado, Régis Ponte, Leal, Renato Mazon Lima Verde, Goes, Annya Costa Araújo de Macedo, Costa, Marcelo Leite Vieira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421572/
https://www.ncbi.nlm.nih.gov/pubmed/37576732
http://dx.doi.org/10.1590/1677-5449.202201081
Descripción
Sumario: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.