Treatment of Hepatic Embryonal Undifferentiated Sarcoma With Cardiothoracic Involvement

2018 ◽  
Vol 11 (4) ◽  
pp. NP199-NP202 ◽  
Author(s):  
Carlos Domínguez-Massa ◽  
Félix Serrano-Martínez ◽  
Óscar R. Blanco-Herrera ◽  
Alberto Berbel-Bonillo ◽  
Fernando Hornero-Sos ◽  
...  

Thorough study is required to decide the appropriate management of hepatic tumors in children. We present a case report of a hepatic embryonal undifferentiated sarcoma with unfavorable prognosis in a nine-year-old girl. After undergoing a detailed cancer characteristics and extension study, a two-stage surgery approach was decided. The hepatic tumor resection was the first procedure to be performed. One week later, under cardiopulmonary bypass, deep hypothermia, and circulatory arrest, thrombectomy of the inferior vena cava and right atrium was accomplished, plus thromboendarterectomy of the right pulmonary artery. During a four-year follow-up, the patient continues to be disease-free.

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Diniz Ferrer ◽  
CARLOS Silveira ◽  
ADRIAN Reis ◽  
PAULA Abreu E Lima ◽  
ROBERT Diniz ◽  
...  

Abstract Funding Acknowledgements governmental grants Uterine leiomyoma is a commom disease in women, however, intravenous leiomyomatosis of uterine origin extending via inferior vena cava into the right side of the heart,known as intracardiac leiomyomatosis is a rare condition (3%). In 1907, Durk reported the first case of intracardiac extension. The patient was a Woman, 35 years old, admitted to our emergency department for an intracardiac mass. She had shortness of breath,fatigue and chest pain. The transthoracic two dimensional echocardiography showed an echogenic oval mass mobile in right atrium and projected through right ventricle in diastole. This mass was observed to extend from inferior vena cava to the right atrium. The echotransesophageal three dimensional showed a large mobile mass that extended from inferior vena cava to the right atrium. A Computer tomographic (CT) scan showed a hypodense multilobulated mass in the pelvis, which had invaded the inferior vena cava and right atrium. The patient underwent a two stages surgery. In first stage (transatrial tumor resection). The operation was performed normal temperature with establisment of cardiopulmonary bypass (CPB). Subsequently, the pathological report was confirmed uterin smooth muscle origin. The second stage surgery ( total histerectomy) was done four weeks later for removing lobulated mass uterin with dimensions 20x15x7.5cm with confirmed histopathological of leiomyoma. Because of it is nonspecific clinical presentation and rarity, an intracardiac Leiomyomatosis continues to be a misdiagnosed as either thrombus or myxoma. The cardiac imaging techniques like a transthoracic echocardiography 2d and transesophageal echocardiography 3d have been used to define the presence, extension of tumor as appearance of the mass and involvement of adjacent structures. Abstract P169 Figure. Echotransesophageal 3D (bicaval view)


2020 ◽  
Vol 92 (4) ◽  
pp. 17-22
Author(s):  
Edward Pietrzyk ◽  
Olga Jelonek ◽  
Iwona Gorczyca ◽  
Piotr Bryk ◽  
Beata Wożakowska-Kapłon ◽  
...  

Introduction: Tumors which most frequently metastasize to the heart include: malignant melanoma, lung cancer, breast cancer, ovarian cancer, kidney cancer, leukemia, lymphomas and esophageal cancer. Purpose: The purpose of this paper was clinical analysis of a group of patients operated in deep hypothermic circulatory arrest due to tumors of the right atrium and the inferior vena cava. Material and method: The study covered 7 patients operated at the Cardiac Surgery Clinic with a cardiac tumor diagnosed on the basis of an echocardiographic assessment in the years 2012–2019. Before qualifying for surgical treatment, each patient underwent: thorough interview and physical examination, 12-lead ECG, laboratory tests and echocardiography. Patients additionally underwent: computed tomography of the chest or abdomen, magnetic resonance imaging and coronary angiography on the basis of which patients with significant coronary artery changes underwent simultaneous coronary artery bypass graft. After preparation, the tumor was excised from the vena cava and right atrium with simultaneous removal of the primary tumor, most often kidney cancer. Early and distant results of treatment were analyzed in the examined group of patients to determine the following endpoints: hospital mortality and survival after surgery: after 3 months and 12 months. Results: Of all operated patients: 2 individuals died in the early postoperative period due to hemorrhagic complications (hospital mortality - 28.6%), and 5 patients (71.4%) were discharged from the Clinic in a good general condition. In total, 3-month survival was 71.4%, and 12-month survival amounted to 28.6%. Conclusions: Surgeries are very complex and challenging, and usually take on average 8-10 hours. It can improve the outcomes of palliative oncological treatment, better physical function (cardiovascular fitness) and extend life from several months to several years in more than 2/3 patients.


2016 ◽  
Vol 9 (3) ◽  
pp. 599-609 ◽  
Author(s):  
Shuichi Fujita ◽  
Hideaki Takahashi ◽  
Yumiko Kanzaki ◽  
Tomohiro Fujisaka ◽  
Yoshihiro Takeda ◽  
...  

A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin) followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abdoulazizi Bilgo ◽  
Amine Saouli ◽  
Ilyass Zerda ◽  
Fouad Zouaidia ◽  
Tarik Karmouni ◽  
...  

Abstract Background Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor that develops from the wall of the IVC and can be confused with many other retroperitoneal tumors. We report the observation of a man with leiomyosarcoma of the vena cava which invades the right kidney. Case presentation 56-year-old man who has seen progress for right back pain for over a year. His thoraco-abdominal-pelvic scanner found a right tumor process measuring 18 × 13 × 18 cm invading the right kidney and the inferior vena cava, heterogeneous in nature, which is enhanced after injection of iodinated contrast product, pushing back the liver and the gall bladder. A border of separation persisted between the mass and the abdominal and thoracic walls. His biological assessment was normal. He underwent an open right nephrectomy with intraoperative bleeding requiring a transfusion of 2 red blood cells. The patient's follow-up period was 8 months without local recurrence or secondary localization. Conclusion The LMS of IVC is a tumor whose management is not yet well codified. Surgery is the only therapeutic means that gives good results, when it is possible. But long-term recurrences remain frequent, which therefore requires prolonged monitoring of these patients.


2017 ◽  
Vol 12 (4) ◽  
pp. 143-149 ◽  
Author(s):  
Anil Bhattarai ◽  
Arben Dedja ◽  
Vladimiro L. Vida ◽  
Francesco Cavallin ◽  
Massimo A. Padalino ◽  
...  

Background & Objectives: To evaluate the advantages of the one and a half ventricle repair on maintaining a low pressure in the inferior vena cava district. Also evaluate the competition of flows at the superior vena cava – right pulmonary artery anastomosis site, in order to understand the hemodynamic interaction of a pulsatile flow in combination to a laminar one. Materials & Methods: Adult rabbits (n=30) in terminal anaesthesia with a follow up of 8 h were used, randomly distributed in three experimental groups: Group 1: animals with an anastomosis between superior vena cava and right pulmonary artery, as a model of one and one half ventricle repair; Group 2: animals with the cavopulmonary anastomosis followed by clamping of the right pulmonary artery proximal to the anastomosis; and Group 3: sham animals. Pressures of superior vena cava and pulmonary arteries were afterwards measured, in a resting condition as well as after induced pharmacological stress test.Results: In Group 1, superior vena cava pressure was significantly higher, while venous pressure in the inferior vena cava – right atrium district was constant or lower in comparison with the other groups. After stress test, the pressure in the superior vena cava and the heart rate both increased further, but the right ventricular, right atrial and pulmonary artery pressures remained similar to the values in a resting condition. This proved that the inferior vena cava return was well-preserved, and no venous hypertension was present in the inferior vena cava district even after stress test (good exercise tolerance).Conclusion: One and one half ventricle repair can be considered a good surgical strategy for maintaining a low pressure in the inferior vena cava district with potential for right ventricle growth, restoring the more physiological circulation in borderline or failing right ventricle conditions. The experiment presented a positive finding in favour of one and one half ventricle repair, as compared to Fontan type procedure.


Phlebologie ◽  
2016 ◽  
Vol 45 (05) ◽  
pp. 322-324
Author(s):  
B. Burkert ◽  
Ph. Regeniter ◽  
A. Mumme ◽  
T. Hummel ◽  
D. Mühlberger

SummaryA case of bilateral iliofemoral thrombosis in a 17-year-old [male] patient is presented. It was only revealed during bilateral transfemoral thrombectomy that the thrombosis was due to previous inferior vena cava occlusion. This required a complex interventional reconstruction of the vena cava with secondary stenting of both renal veins. The postoperative venogram showed blood outflow from the left renal vein into the portal vein and from the right renal vein into the inferior vena cava via collaterals. At follow-up presentation, the patient was asymptomatic with normal findings on computed tomography scanning.


Sign in / Sign up

Export Citation Format

Share Document