Hajji Fouad, Azami Mohamed A, Adlouni Sanaa, Benazzouz Abderrazak, Ghoundale Omar
Department of Urology, Cadi Ayyad University, Ibn Sina Military Hospital, Marrakech, MAR.
Department of Pathology, Cadi Ayyad University, Ibn Sina Military Hospital, Marrakech, MAR.
Cureus. 2022 Aug 28;14(8):e28510. doi: 10.7759/cureus.28510. eCollection 2022 Aug.
Retroperitoneal vascular leiomyosarcoma (RVLMS) are rare soft-tissue sarcomas that most commonly arise from large blood vessels and have a poor prognosis. We present the case of a 61-year-old woman who presented with isolated left flank pain. Abdominal computed tomography and magnetic resonance imaging revealed a 5 cm retroperitoneal soft-tissue mass that was contiguous with the left ovarian vein and connected to the proximal ureter, causing hydronephrosis. As ureteroscopy suggested extrinsic compression of the ureter, a percutaneous biopsy of the mass was obtained, whereupon diagnosis of leiomyosarcoma was made. Radical en-bloc excision of the tumor, including the involved upper urinary tract and the gonadal vein, was performed. The tumor proved to be a leiomyosarcoma arising from the ovarian vein wall. No adjuvant therapy was planned, and no recurrence was noticed at her 24-month follow-up. Primary RVLMS of the ovarian vein is an uncommon condition. To date, only a few sporadic cases have been reported in the literature. What makes the present case further interesting is the unusual tumor's relationship with the patient's ureter, raising both diagnostic and management challenges. To our best knowledge, this is so far the fourth reported case of its kind to cause ureteral obstruction.
腹膜后血管平滑肌肉瘤（RVLMS）是一种罕见的软组织肉瘤，最常见于大血管，预后较差。我们报告一例61岁女性，以孤立性左腰痛就诊。腹部计算机断层扫描和磁共振成像显示一个5厘米的腹膜后软组织肿块，与左卵巢静脉相邻并与近端输尿管相连，导致肾积水。由于输尿管镜检查提示输尿管受到外部压迫，遂对肿块进行经皮活检，诊断为平滑肌肉瘤。对肿瘤进行了根治性整块切除，包括受累的上尿路和性腺静脉。肿瘤证实为起源于卵巢静脉壁的平滑肌肉瘤。未计划辅助治疗，在24个月的随访中未发现复发。卵巢静脉原发性RVLMS是一种罕见情况。迄今为止，文献中仅报道了少数散发病例。本病例更有趣的是该不寻常肿瘤与患者输尿管的关系，这带来了诊断和治疗方面的挑战。据我们所知，这是迄今为止第四例报道的此类导致输尿管梗阻的病例。
