We present a 56-year-old woman affected by a large leiomyosarcoma originating from the suprarenal inferior vena cava (IVC). A computed tomography (CT) scan revealed near obstruction of the IVC and involvement of the right renal vein. The patient underwent successful en bloc resection of the tumor, right kidney, right adrenal gland, and IVC. Caval reconstruction was performed using a non-type specific allograft, followed by left renal vein re-implantation. The patient tolerated the procedure well without any complications. The use of an IVC allograft allowed for continued graft patency, without the need of immunosuppression or long-term anticoagulation. However, local recurrence did occur.
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Article Synopsis
- Primary liver cancer, mainly hepatocellular carcinoma (HCC), is a major cause of cancer deaths, and tumor thrombus (TT) in major vessels worsens patient outcomes.
- Four male HCC patients (average age 57) with TT in the inferior vena cava or right atrium underwent surgery to remove the tumors, followed by targeted and immunotherapy.
- All cases show positive outcomes post-treatment, with some patients remaining disease-free for up to 74 months, suggesting that combining surgery with therapy could improve survival rates in advanced HCC patients.
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