Complete Surgical Resection of a Leiomyosarcoma Arising from the Inferior Vena Cava

A 76-year-old Japanese man was referred to our hospital with chief complaint of right hypochondoralgia. Abdominal ultrasound showed a retroperitoneal tumor in the suprarenal region of the right kidney. Computed tomography revealed an enhanced lobular tumor with irregular, circumscribed, and indistinct border. Ultrasound-guided biopsy was performed. The tumor consisted of spindle-shaped cells with a giant nucleus and multinuclear cells. The diagnosis was leiomyosarcoma by immunohistochemical staining. The patient underwent surgery accessed by a right eighth intercostal thoracoabdominal incision. The tumor was completely resected, accompanied by removal of the posterosuperior segment of the right hepatic lobe, right adrenal gland, and a portion of the inferior vena cava (IVC). The histopathologic diagnosis was leiomyosarcoma arising from the IVC. We present a rare case of a successfully managed leiomyosarcoma of the IVC. This case suggests the importance of curative surgical resection of the tumor due to low efficacy of adjuvant chemotherapy for leiomyosarcoma.

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Intravascular leiomyomatosis with cardiac extension: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytac001 ◽

2022 ◽

Author(s):

Einat Shaked ◽

Ram Sharoni ◽

Debra Gershov West ◽

Eli I Lev

Keyword(s):

Inferior Vena Cava ◽

Clinical Condition ◽

Heart Surgery ◽

Inferior Vena ◽

Multimodality Imaging ◽

Open Heart Surgery ◽

Vena Cava ◽

Abdominal Ultrasound ◽

Right Heart ◽

The Right

Abstract Background Intravascular leiomyomatosis with intracardiac extension is a rare benign tumor seen exclusively in women, characterized by proliferation of uterine smooth muscle cells through the venous circulation into the inferior vena cava and the right heart chambers. Case summary A 47 years old women with history of previous hysterectomy due to myomatosis, presented with nausea, anorexia and bilateral lower limb swelling over the preceding two months. An outpatient abdominal ultrasound discovered a mass in the Inferior vena cava. Echocardiogram and Computed tomography demonstrated a large intravascular mass extending from the pelvis to the right heart chambers. The tumor was completely removed in a concomitant open-heart surgery and laparotomy. Post operative course was uncomplicated. A month later the patient was feeling well and in good clinical condition. The histological analysis consisted with intravascular leiomyomatosis. Discussion Intracardiac leiomyomatosis is a rare clinical condition which requires high index of suspicion. Multimodality imaging is usually required to establish the preoperative diagnosis, although the final diagnosis is achieved with tissue investigation. Complete surgical resection of the tumor is curative and associated with good long-term prognosis.

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Anesthetic management of gigantic pheochromocytoma resection with inferior vena cava and right atrium tumor thrombosis: A case report

10.21203/rs.2.301/v1 ◽

2019 ◽

Author(s):

Jingli Chen ◽

Caihua Liu ◽

Chang Liu ◽

Quanyuan Fu ◽

Dingwei Peng ◽

...

Keyword(s):

Inferior Vena Cava ◽

Surgical Resection ◽

Right Atrium ◽

Inferior Vena ◽

Anesthetic Management ◽

Vena Cava ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

The Right

Abstract Background: This report describes one case of anesthetic management about surgical resection of a malignant phaeochromocytoma with tumor extension into vena cava and right atrium in a patient. Report for anesthetic management is limited in these patients under surgical resection until now. Case presentation: In September 2015, a 24-year-old male presented to the department of cardiology with right flank pain and hypertensive urgency in our hospital. Contrast-enhanced CT abdomen and MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Echocardiography shown no abnormal detection. Finally, this patient gave up the surgical resection of phaeochromocytoma and chose the expectant treatment. In April 2018, this patient once again presented to the emergence department with a persistent cough and intermittent wheezing character for 5 hour. Contrast-enhanced CT and echocardiography shown existing IVC thrombus had extended into the right atrium. After the careful preoperative preparation, adrenalectomy with complete thrombus excision by inferior vena cava exploration and right atriotomy were performed successfully by a multidisciplinary team. After one month post-operation care, the patient healthily leave our hospital. Conclusion: To the best of our knowledge, the occurrence of pheochromocytoma in IVC and right atrium thrombosis has not been reported so far from mainland China. This clinical case may supply a rare reference experience for surgical treatment and anesthetic management in the group of phaeochromocytoma patient with distance vascular extension. Keywords: Adrenal tumor; Malignant phaeochromocytoma; Inferior vena cava; Right atrium; Tumor thrombus.

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Anesthetic management of gigantic pheochromocytoma resection with inferior vena cava and right atrium tumor thrombosis: A case report

10.21203/rs.2.301/v2 ◽

2019 ◽

Author(s):

Jingli Chen ◽

Caihua Liu ◽

Chang Liu ◽

Quanyuan Fu ◽

Dingwei Peng ◽

...

Keyword(s):

Inferior Vena Cava ◽

Surgical Resection ◽

Right Atrium ◽

Inferior Vena ◽

Anesthetic Management ◽

Vena Cava ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

The Right

Abstract Background: This report describes one case of anesthetic management about surgical resection of a malignant phaeochromocytoma with tumor extension into vena cava and right atrium in a patient. Report for anesthetic management is limited in these patients under surgical resection until now. Case presentation: In September 2015, a 24-year-old male presented to the department of cardiology with right flank pain and hypertensive urgency in our hospital. Contrast-enhanced CT abdomen and MRI abdomen revealed a mass phaeochromocytoma in right adrenal, which invaded the right inferior vena cava（IVC）wall along with IVC thrombus. Echocardiography shown no abnormal detection. Finally, this patient gave up the surgical resection of phaeochromocytoma and chose the expectant treatment. In April 2018, this patient once again presented to the emergence department in our hospital, he had experienced persistent cough and intermittent wheezing for 5 hour. Contrast-enhanced CT and echocardiography shown existing IVC thrombus had extended into the right atrium. After the careful preoperative preparation, adrenalectomy with complete thrombus excision by inferior vena cava exploration and right atriotomy were performed successfully by a multidisciplinary team. After one month post-operation care, this patient healthily left our hospital. Conclusion: To the best of our knowledge, the occurrence of pheochromocytoma with IVC and right atrium thrombosis has not been reported in mainland China so far. This clinical case may supply a rare reference experience for surgical treatment and anesthetic management in the group of phaeochromocytoma patient with distance vascular extension.

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Emphysematous pyelonephritis with air bubble in the inferior vena cava

African Journal of Urology ◽

10.1186/s12301-020-00081-2 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Tiffany A. Perkins ◽

Alberic Rogman ◽

Murali K. Ankem

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Case Presentation ◽

Air Bubble ◽

First Case ◽

The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

Vascular and Endovascular Surgery ◽

10.1177/15385744211002026 ◽

2021 ◽

pp. 153857442110020

Author(s):

Reza Talaie ◽

Hamed Jalaeian ◽

Nassir Rostambeigi ◽

Anthony Spano ◽

Jafar Golzarian

Keyword(s):

Inferior Vena Cava ◽

Transjugular Intrahepatic Portosystemic Shunt ◽

Inferior Vena ◽

Vena Cava ◽

Portosystemic Shunt ◽

Hepatic Veins ◽

Budd Chiari Syndrome ◽

Chiari Syndrome ◽

Intrahepatic Portosystemic Shunt ◽

The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

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Surgical Resection of Tumors Invading the Inferior Vena Cava at the Hepatic Vein and Thoracic Levels

World Journal of Surgery ◽

10.1007/s00268-021-06227-9 ◽

2021 ◽

Author(s):

Justin Issard ◽

Antonio Sa Cunha ◽

Dominique Fabre ◽

Delphine Mitilian ◽

Sacha Mussot ◽

...

Keyword(s):

Inferior Vena Cava ◽

Surgical Resection ◽

Hepatic Vein ◽

Inferior Vena ◽

Vena Cava

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Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

Journal of Endovascular Therapy ◽

10.1177/15266028211025024 ◽

2021 ◽

pp. 152660282110250

Author(s):

Yun Chul Park ◽

Hyoung Ook Kim ◽

Nam Yeol Yim ◽

Byung Chan Lee ◽

Chan Park ◽

...

Keyword(s):

Case Report ◽

Inferior Vena Cava ◽

Stent Graft ◽

Inferior Vena ◽

Vena Cava ◽

Endovascular Management ◽

Top Down ◽

Life Threatening ◽

The Right ◽

Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

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Hypotension in the Right Lateral Position Secondary to Inferior Vena Cava Abnormality

A & A Case Reports ◽

10.1213/xaa.0000000000000195 ◽

2015 ◽

Vol 5 (6) ◽

pp. 103-105 ◽

Cited By ~ 1

Author(s):

Meredith J. H. Hutton ◽

Ganesh Swamy ◽

Kelly Shinkaruk ◽

Kaylene Duttchen

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Lateral Position ◽

The Right

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Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

Case Reports in Vascular Medicine ◽

10.1155/2013/489373 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Christian Steinberg ◽

Suzanne Boudreau ◽

Felix Leveille ◽

Marc Lamothe ◽

Patrick Chagnon ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Inferior Vena Cava ◽

Right Atrium ◽

Inferior Vena ◽

Vena Cava ◽

Great Majority ◽

Right Atrial ◽

Advanced Hepatocellular Carcinoma ◽

Regional Lymph Nodes ◽

The Right

Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

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