Veroux P, Veroux M, Nicosia A, Bonanno M G, Tumminelli M G, Milone P, Petrillo G
Department of Surgery and Transplantation, Policlinic of University of Catania, Italy.
J Surg Oncol. 2000 May;74(1):45-8. doi: 10.1002/1096-9098(200005)74:1<45::aid-jso11>3.0.co;2-k.
We report a rare case in which a patient successfully underwent surgical removal from the inferior vena cava of a neoplastic thrombus induced by a recurrent low-grade endometrial stromal sarcoma. The patient was admitted with severe acute renal failure and a large edema on the right lower extremity. One year previously she had undergone hysterectomy and adnexectomy due to an endometrial stromal sarcoma with involvement of the tuba. Because of complete thrombosis of the right internal and common iliac veins and the inferior vena cava, she underwent thrombectomy of the inferior vena cava. The postoperative course was complicated by hydruric renal failure induced by a acute tubular necrosis. At 6-month follow-up, the patient was asymptomatic with normal renal function. The ileocaval axis was patent on magnetic resonance imaging. Only 5 cases of intracaval extension of endometrial stromal sarcoma have been reported. Surgical treatment is viable due to excellent prognosis of the low-grade endometrial stromal sarcoma (80-100% 5-year survival) and likely fatal heart failure in untreated cases.
我们报告了一例罕见病例，一名患者成功接受手术，从下腔静脉取出由复发性低级别子宫内膜间质肉瘤引起的肿瘤血栓。该患者因严重急性肾衰竭和右下肢重度水肿入院。一年前，她因患有累及输卵管的子宫内膜间质肉瘤接受了子宫切除术和附件切除术。由于右髂内静脉、髂总静脉和下腔静脉完全血栓形成，她接受了下腔静脉血栓切除术。术后过程因急性肾小管坏死导致的水尿性肾衰竭而复杂化。在6个月的随访中，患者无症状，肾功能正常。磁共振成像显示回腔轴通畅。仅报道了5例子宫内膜间质肉瘤腔静脉内扩展的病例。由于低级别子宫内膜间质肉瘤预后良好（5年生存率80 - 100%），且未经治疗的病例可能发生致命的心力衰竭，手术治疗是可行的。
