Leiomyosarcoma of the renal vein: analysis of outcome and prognostic factors in the world case series of 67 patients

Abstract Background Leiomyosarcoma is a rare malignant mesenchymal tumour. Some cases of leiomyosarcoma of the renal vein (LRV) have been reported in the literature, but no analysis of data and search for prognostic factors have been done so far. The aim of this review was to describe the LRV, to analyse overall survival (OS), local recurrence free survival (LRFS) and distant metastases free survival (DMFS) in LRV world case series and to identify significant predictors of OS, LRFS and DMFS. Methods Cases from the literature based on PubMed search and a case from our institution were included. Results Sixty-seven patients with a mean age of 56.6 years were identified; 76.1% were women. Mean tumour size was 8.9 cm; in 68.7% located on the left side. Tumour thrombus extended into the inferior vena cava lumen in 13.4%. All patients but one underwent surgery (98.5%). After a median follow up of 24 months, the OS was 79.5%. LRFS was 83.5% after a median follow up of 21.5 months and DMFS was 76.1% after a median follow up of 22 months. Factors predictive of OS in univariate analysis were surgical margins, while factors predictive of LRFS were inferior vena cava luminal extension and grade. No factors predictive of DMFS were identified. In multivariate analysis none of the factors were predictive of OS, LRFS and DMFS. Conclusions Based on the literature review and presented case some conclusions can be made. LRV is usually located in the hilum of the kidney. It should be considered in differential diagnosis of renal and retroperitoneal masses, particularly in women over the age 40, on the left side and in the absence of haematuria. Core needle biopsy should be performed. Patients should be managed by sarcoma multidisciplinary team. LRV should be surgically removed, with negative margins.

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Surgical Approach to a Large Left Adrenocortical Mass with Associated Tumour Thrombosis of the Left Renal Vein: Preservation of the Ipsilateral Kidney

Advances in Urology ◽

10.1155/2009/365805 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Manuel Pérez Utrilla ◽

Carlos Nuñez Mora ◽

Alejandro Rojo Sebastián ◽

Pedro M. Cabrera Castillo ◽

José M. García Mediero

Keyword(s):

Renal Function ◽

Inferior Vena Cava ◽

Surgical Approach ◽

Renal Vein ◽

Adrenal Mass ◽

Inferior Vena ◽

Elective Surgery ◽

Left Renal Vein ◽

Vena Cava ◽

Tumour Thrombus

A sixty-years-old male with diagnosis of a left adrenal mass ( mm) with associated tumour thrombosis of the left renal vein with no clear signs of thrombosis of the inferior vena cava was admitted for elective surgery Finally an adrenalectomy and excision of tumour thrombus preserving the ipsilateral kidney was made. Despite of the complex vascular management, this kind of approaches allow to preserve normal renal function in patients with future nephrotoxic treatment like cisplatin.

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Previous vena cava occlusion as the cause of a bilateral iliofemoral thrombosis

Phlebologie ◽

10.12687/phleb2323-5-2016 ◽

2016 ◽

Vol 45 (05) ◽

pp. 322-324

Author(s):

B. Burkert ◽

Ph. Regeniter ◽

A. Mumme ◽

T. Hummel ◽

D. Mühlberger

Keyword(s):

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Left Renal Vein ◽

Vena Cava ◽

Inferior Vena Cava Occlusion ◽

Computed Tomography Scanning ◽

Iliofemoral Thrombosis ◽

The Right

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.

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Urothelial carcinoma of the renal pelvis with renal vein and inferior vena cava tumor thrombus: case series and literature review

Translational Andrology and Urology ◽

10.21037/tau-21-253 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Xiaojun Tian ◽

Peng Hong ◽

Shiying Tang ◽

Zhuo Liu ◽

Feilong Yang ◽

...

Keyword(s):

Literature Review ◽

Inferior Vena Cava ◽

Urothelial Carcinoma ◽

Renal Pelvis ◽

Renal Vein ◽

Tumor Thrombus ◽

Inferior Vena ◽

Vena Cava ◽

Case Series

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Malignant epithelioid angiomyolipoma invading inferior vena cava: Using a temporary vena cava filter to prevent tumor emboli during nephrectomy.

Canadian Urological Association Journal ◽

10.5489/cuaj.1814 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 564 ◽

Cited By ~ 7

Author(s):

Xiang Li ◽

Runming Liu ◽

Dalin He

Keyword(s):

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Pulmonary Complication ◽

Vena Cava ◽

Ivc Filter ◽

Epithelioid Angiomyolipoma ◽

Tumour Thrombus ◽

Tumor Emboli ◽

Tomography Scan

Angiomyolipoma (AML) is generally considered to be benign and malignant angiomyolipoma is rare. This paper presents an extremely rare case of epithelioid AML with tumour thrombus invading inferior vena cava (IVC). We present the case of a 36-year-old woman with epithelioid AML with tumour thrombus invading inferior vena cava who underwent radical nephrectomy and IVC thrombectomy. As an adjunctive procedure, a temporary IVC filter was placed in suprarenal position before operation. One week after surgery, the temporary IVC filter was retrieved by femoral approach. Three months postoperatively, a computed tomography scan and abdominal ultrasonogaphy showed no evidence of thrombus in IVC or renal vein and no sign of tumour recurrence. Epithelioid AML is extremely rare and can be malignant, with invasion of the IVC or renal vein. Implanting temporary filter can prevent fatal pulmonary complication and avoid potential the side effects of permanent filter.

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A 10-Year Experience of Leiomyosarcoma of the Inferior Vena Cava

10.21203/rs.3.rs-797182/v1 ◽

2021 ◽

Author(s):

Jun Pan ◽

Chenyang Qiu ◽

Yangyan He ◽

Xing Xue ◽

Donglin Li ◽

...

Keyword(s):

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Primary Repair ◽

Tumor Resection ◽

Vena Cava ◽

Clinical Manifestations ◽

R0 Resection ◽

Term Survival

Abstract Background: Leiomyosarcoma of the inferior vena cava (IVC) is rare. The study reviewed patients with IVC leiomyosarcoma in our hospital in the past ten years.Methods: 20 patients diagnosed with IVC leiomyosarcoma between October 2010 and October 2020 were enrolled. Their clinical manifestations, treatments and follow-up results were analyzed.Results: The sarcoma was located in the lower IVC segment in six patients, with 13 in the middle IVC segment and one in the upper IVC segment. The median tumor size was 8.5 cm (range 2.5-27.0). Except for two patients who underwent partial resection, other patients underwent R0 resection. After resection, 16 patients (80%) had primary repair of the IVC, while four patients underwent ligation. Three patients with tumors invading the renal vein but not the kidney underwent renal vein revascularization. There was no perioperative death. During a mean follow-up of 37.7 months, seven patients died due to tumor metastasis, four patients were alive with the tumor recurrence and other nine patients were alive without recurrence.Conclusion: The perioperative mortality was low. The management of the IVC after tumor resection depended on the tumor location and size. R0 resection provided a chance for long term survival.

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Renal cell carcinoma extending to the renal vein and inferior vena cava: Results of surgical treatment and prognostic factors

Journal of Surgical Oncology ◽

10.1002/jso.2930590205 ◽

1995 ◽

Vol 59 (2) ◽

pp. 94-100 ◽

Cited By ~ 37

Author(s):

Hemant B. Tongaonkar ◽

Niteen P. Dandekar ◽

Amish V. Dalal ◽

Jagdeesh N. Kulkarni ◽

Murali R. Kamat

Keyword(s):

Renal Cell Carcinoma ◽

Prognostic Factors ◽

Surgical Treatment ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Vein ◽

Inferior Vena ◽

Vena Cava

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A cut above? Inferior vena cava resection without reconstruction: a dual-centre experience

Journal of Clinical Urology ◽

10.1177/2051415820947638 ◽

2020 ◽

pp. 205141582094763

Author(s):

Jonathan P Noël ◽

Sarah Yu Weng Tang ◽

Nana Aishatu Liman Muhammad ◽

David Nicol ◽

Roger C Kockelbergh

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Cell Cancer ◽

Vena Cava ◽

Case Series ◽

Safe Procedure ◽

Level Of Evidence ◽

Chyle Leak ◽

Ivc Resection

Objectives: To evaluate outcomes in our patients undergoing inferior vena cava (IVC) resection without reconstruction, as part of an adrenal/renal cell cancer (RCC) operation. Methods: British Association of Urological Surgeons (BAUS) Data and Audit System records were obtained for two operating surgeons, each at geographically separate urological cancer centres. Retrospectively reviewed case notes of patients who had undergone IVC resection without reconstruction as part of an adrenal/RCC operation, assessing operative parameters, length of stay, complications and follow-up status. Results: A total of Twenty-eight patients (20 right-sided tumours, 8 left sided) underwent IVC resection without reconstruction in May 2013–February 2017. No perioperative or early deaths occurred. Fourteen patients (50%) had complications: sepsis; pneumonia; congestive cardiac failure; acute kidney injury; symptomatic peripheral deep venous thrombosis; splenectomy; and significant chyle leak. At a median follow-up of 21 months (range 1–55 months) six patients (21.4%) have died and two patients (7.1%) progressed to metastatic disease, giving a 71.4% progression-free survival in this series. Conclusions: This case series illustrates our experience of IVC resection without reconstruction as an acceptably safe procedure. This should be considered as an alternative to graft reconstruction, particularly as minimal invasive approaches are being adopted. Level of Evidence: 3

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Obstruction of the inferior vena cava following bicaval orthotopic heart transplantation: a case series

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab046 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Anas Abudan ◽

Brent Kidd ◽

Peter Hild ◽

Bhanu Gupta

Keyword(s):

Inferior Vena Cava ◽

Heart Transplantation ◽

Inferior Vena ◽

Rare Complication ◽

Vena Cava ◽

Case Series ◽

Transoesophageal Echocardiography ◽

Right Atrial ◽

Orthotopic Heart Transplantation ◽

Eustachian Valve

Abstract Background Inferior vena cava (IVC) obstruction is a rare complication of orthotopic heart transplantation (OHT) and is unique to bicaval surgical technique. The clinical significance, diagnosis, complications, and management of post-operative IVC anastomotic obstruction have not been adequately described. Case summary Two patients with end-stage heart failure presented for bicaval OHT. Post-operative course was complicated with shock refractory to fluid resuscitation and inotropic/vasopressor support. Obstruction at the IVC-right atrial (RA) anastomosis was diagnosed on transoesophageal echocardiography (TOE), prompting emergent reoperation. In both cases, a large donor Eustachian valve was found to be restricting flow across the IVC-RA anastomosis. Resection of the valve resulted in relief of obstruction across the anastomosis and subsequent improvement in haemodynamics and clinical outcome. Discussion Presumably rare, we present two cases of IVC obstruction post-bicaval OHT. Inferior vena cava obstruction is an under-recognized cause of refractory hypotension and shock in the post-operative setting. Prompt recognition using TOE is crucial for immediate surgical correction and prevention of multi-organ failure. Obstruction can be caused by a thickened Eustachian valve caught in the suture line at the IVC anastomosis, which would require surgical resection.

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