LEIOMYOSARCOMA OF THE INFERIOR VENA-CAVA - NOVEL SURGICAL RECONSTRUCTION PRESERVES RENAL-FUNCTION

Leiomyosarcoma of the inferior vena cava is rare and to date 145 cases have been reported. Here a new case of primary leiomyosarcoma of the inter-renal vena cava is reported. Surgical treatment consisted of exc ision of the vena cava on top of the renal arteries allowing radical r esection. Reconstruction was original. The distal vena cava was sectio ned and ligated just above the bifurcation and the free segment used t o replace the excised part. In this the right venal vein was directly implanted. The left renal vein was reimplanted in the translocated seg ment via a venous (femoral vein) graft, Ligation of the distal vena ca va was haemodynamically well-tolerated and the patient was free of sym ptoms at one year after operation. Control angiogram showed patency of the venous reconstruction. Early diagnosis is essential to improve pa tient survival, since it allows better radical resection, which is the only way of preventing the development of metastases.