Zaenkert EK, Bruns CJ, Winter H, Rentsch M, Jauch KW, Hardin G, Angele MK. Resection of sarcoma involving the intrahepatic vena cava: report of 2 cases from a specialized center.
Ann Vasc Surg 2013;
27:498.e9-13. [PMID:
23541777 DOI:
10.1016/j.avsg.2012.06.018]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 05/15/2012] [Accepted: 06/14/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND
Primary leiomyosarcoma (LMS) of the hepatic vena cava is a rare malignancy that has only been published in case reports. Only a few cases with successful R0 resection have been reported in the literature.
METHODS
We report 2 similar cases of extended primary LMS of the intrahepatic inferior vena cava (IVC). Both patients previously underwent operations in nonspecialized centers that resulted in inadequate tumor resection. After admission to a high-volume center focusing on the treatment of patients with sarcoma, R0 resection was feasible with a multimodal therapeutic treatment approach.
RESULTS
Radical complete tumor resection was achieved by means of extended right-sided hemihepatectomy (segments V-VIII and I), en bloc resection, and prosthetic replacement of the IVC and nephrectomy in 1 patient. Both patients are currently tumor-free and healthy 6 months postoperatively.
CONCLUSIONS
Patients with such complex tumors should be referred to centers with specialized surgeons who can preoperatively estimate whether complete resection may be possible and who are capable of performing such delicate interventions.
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