Retroperitoneal Leiomyosarcoma: Surgical Treatment of Invasion to the Inferior Vena Cava

Abstract

Retroperitoneal leimyosarcoma is rare and surgical resection is the most effective treatment. However, the prognosis is poor due to local recurrence in spite of complete resection. The invasion to the large vessels, especially to the inferior vena cava (IVC), poses a technical challenge during operation. Special care should be taken to prevent unexpected exsanguinations and tumor emboli during manipulation of the IVC. We experienced three patients with retroperitoneal leiomyosarcoma invading to the IVC. One was primary and two were recurrent cases. The isolation was performed along the adventitia of the vessels, and the tumor could be removed safely and completely with part of IVC. The advanced tumor in the lumen could be pulled out from the inferior vena cava. In the two recurrent cases, the pain was relieved and the life prolonged. The retroperitoneal leiomyosarcoma, which invades the inferior vena cava, could be removed completely and safely by primary isolation of the large vessels in spite of the tumor capsule.