Indian J Surg | December 2005 | Volume 67 | Issue 6 320 320 CMYK Leiomyosarcoma of the inferior vena cava: Leiomyosarcoma of the inferior vena cava: Leiomyosarcoma of the inferior vena cava: Leiomyosarcoma of the inferior vena cava: Leiomyosarcoma of the inferior vena cava: report of a case report of a case report of a case report of a case report of a case G. Gurleyik, A. Aktekin, A. Arman 1 , T. Muftuoglu, A. Saglam Departments of Surgery and 1 Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey For correspondence: Dr. G. Gurleyik, Eski Bagdat Cad. 29/9 Istanbul, Turkey. E-mail: ggurleyik@yahoo.com ABSTRACT Leiomyosarcoma of inferior vena cava is a rare soft tissue sarcoma presenting with vague abdominal pain. Complete surgical resection with clear surgical margin plays a central therapeutic role. The effect of chemotherapy and radiation therapy is controversial. We reported a female patient with invasion both renal veins by this disease. It was surgically excised and replaced with graft and right renal vein was anastomosed to graft without any complications. Histopathological examination of the specimen grade II leiomyosarcoma arising from the vena cava. She is alive at 36th month. Key words: Graft, leiomyosarcoma, vena cava inferior How to cite this article: Gurleyik G, Aktekin A, Arman A, Muftuoglu T, Saglam A. Leiomyosarcoma of the inferior vena cava: report of a case. Indian J Surg 2005;67:320-2. Case Report Case Report Case Report Case Report Case Report Paper Received: March, 2005. Paper Accepted: May, 2005. Source of Support: Nil. Leiomyosarcoma (LMS) is 10–15% of soft tis- sue sarcomas, but represent 45% of all retro- peritoneal malignancies. [1] LMS arising from inferior vena cava (IVC) are very rare and re- ported over 200 cases since by Perl’s in 1871. [2] It originates from media of the vein and can expand intraluminally, extraluminally or both. We report our surgically treated patient with LMS of the IVC. CASE REPORT Our patient was a 63-year-old woman. During the last 3 months her main complain was col- icky abdominal pain located in the right up- per quadrant. Physical examination was un- remarkable. Abdominal ultrasound reported a conglomerated lymph nodes mass of 66 x 48 mm 2 in size compressing portal vein and spleno-portal union at pancreatic level. Ab- dominal CT and MRI showed a heterogene- ous, solid mass of 7 x 7 x 4 cm 3 which was located between inferior edge of quadrate lobe of liver and third portion of duodenum. It was posterior to left kidney and left adrenal gland, compressing IVC and right renal vein. The pathologist reported a diagnosis of low grades LMS after ultra- sound-guided true-cut biopsy led us to a diagnosis of a retroperitoneal LMS. During operation, we recognized a 10 cm mass originated from subhepatic IVC, adja- cent to caudate lobe of the liver, displacing the pan- creas and duodenum to the anterior. Both renal veins were invaded by the tumor (Figure 1). Left renal vein had not function, but another inferior polar left renal Figure 1: Intraoperative photograph of the tumor. VCI, vena cava inferior; RRV, right renal vein