Abstract
Introduction: Sarcomas are generally among the most malignant neoplasms. Unfortunately, they are only diagnosed after they have reached an advanced state.
Despite a multidisciplinary approach, these tumours have a very poor prognosis. If sarcomas arise from the inferior vena cava, ninety-five percent of them are diagnosed as leiomyosarcomas.
These tumours originate from the smooth muscle cells of the tunica media. A total of 400 cases have been described worldwide.
Symptoms depend on the size of the tumour and its location. It is clear that surgical resection prolongs survival of patients.
Case: A 50-year-old female patient with an incidental finding of leiomyosarcoma of the inferior vena cava underwent radical surgical treatment at our clinic - resection of the tumour and venorrhaphy of the inferior vena cava. Three and a half years after the procedure, we discovered a local recurrence of the sarcoma in the afflicted area of the inferior vena cava.
At the outset, the patient underwent proton radiotherapy to reduce the tumour mass and was subsequently operated - 4.3 years after the initial surgery. The afflicted segment was replaced by a Goretex prosthesis during the procedure.
A follow-up CT, 4.8 years after the initial diagnosis, shows no recurrence. Conclusion: Radical resection of a tumour located in the inferior vena cava significantly prolongs the life of the patient.
Interventions in the inferior vena cava usually only require temporary anticoagulant therapy. In our case, we performed a caval resection and venorrhaphy due to leiomyosarcoma, and 4.3 years after the initial surgery, we needed to replace the afflicted section with a prosthesis due to recurrence of the disease.
Four months after the second procedure, the patient is reported to be in good condition.