Sokolich Julio, Mejia Alejandro, Cheng Stephen, Dunn Ernest
Department of Surgery, Methodist Dallas Medical Center, Dallas, Texas 75265-5999, USA.
Am Surg. 2008 May;74(5):433-6.
Leiomyosarcoma of the inferior vena cava (IVC) is a rare sarcoma, but it is the most common primary malignancy of the IVC. It has an extremely poor prognosis. We describe a 60-year-old white female complaining of abdominal fullness for 7 weeks before she sought medical assistance. Initial work-up including sonography, computed tomography, and magnetic resonance showed a tumor in the right upper quadrant of the abdominal cavity originating from the liver with compression of the IVC and displacement of the right kidney. The patient underwent surgical resection of the tumor with clear margins and reconstruction of the IVC using a Dacron tubular graft. Postoperatively, she was placed on Coumadin and adjuvant chemotherapy was started. Subsequently, the patient developed metastasis into the liver and peripancreatic nodes during the follow-up period. Considering the aggressiveness of this tumor, early radical en block resection with clear margins is still the only chance for long-term survival.
下腔静脉平滑肌肉瘤是一种罕见的肉瘤，但却是下腔静脉最常见的原发性恶性肿瘤。其预后极差。我们描述了一名60岁的白人女性，在寻求医疗帮助前7周一直抱怨腹部胀满。包括超声、计算机断层扫描和磁共振成像在内的初步检查显示，腹腔右上象限有一个源于肝脏的肿瘤，压迫下腔静脉并使右肾移位。患者接受了肿瘤的手术切除，切缘清晰，并使用涤纶管状移植物重建下腔静脉。术后，她开始服用香豆素并接受辅助化疗。随后，患者在随访期间出现肝转移和胰周淋巴结转移。鉴于这种肿瘤的侵袭性，早期进行切缘清晰的根治性整块切除仍是长期生存的唯一机会。
