Leiomyosarcoma of the inferior vena cava: Curative resection and synchronous reconstruction of bilateral renal veins

Leiomyosarcoma of the inferior vena cava (IVC) is a malignant tumor of mesenchymal origin. Surgical treatment should include complete resection of the malignant lesion with preservation of venous return. A 53-year-old woman, was referred to our hospital for recurrent upper abdominal discomfort. Computed tomography scan revealed a poorly-margined mass located between the pancreatic head and the right kidney, invading into inferior vena cava and bilateral renal veins. During surgical resection of the tumor, IVC and bilateral renal veins were clamped and the tumor was subsequently removed. The distal end of IVC was resected and venous prosthetic grafts were inserted into the proximal end and bilateral renal veins were reconstructed. Histological findings revealed leiomyosarcoma, originating from the IVC and infiltrating into bilateral renal veins. The patient has remained disease free after treatment. Though chemoradiotherapy may serve as adjuvant to surgical resection, complete surgical resection should also be recommended.