Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada.
Curr Oncol. 2024 Jul 9;31(7):3978-3984. doi: 10.3390/curroncol31070294.
Inferior vena cava (IVC) compression secondary to mass effect is accompanied by edema, ascites, back and abdominal pain, and central nervous system symptoms. Most IVC syndrome cases described in the literature focus on the focal treatment of IVC lesions, and reports of complete iliocaval reconstructions secondary to malignant IVC syndrome in the palliative context are limited. In this case report, we describe the clinical presentation, technical approach, and symptomatic outcomes of a patient with extensive malignant compression and invasion of the iliofemoral venous system. An 82-year-old male with metastatic lung cancer invading the right upper quadrant of the abdomen presented with scrotal and bilateral lower extremity edema, as well as anasarca. Computed tomography (CT) demonstrated an 11 cm right adrenal metastasis and extensive retroperitoneal lymphadenopathy resulting in the compression of the IVC and iliac veins. Femoral venography demonstrated extensive collateral venous pathway formation with the opacification of the para-lumbar and vertebral veins, in addition to the vertebral/sacral venous plexus. Iliocaval reconstruction was performed using venous-dedicated stents. This case report highlights a technically successful total iliocaval reconstruction in a complex palliative patient with diffuse metastatic disease resulting in IVC compression and syndrome.
下腔静脉（IVC）受压继发于肿块效应，伴有水肿、腹水、腰背疼痛和中枢神经系统症状。文献中描述的大多数 IVC 综合征病例都集中在 IVC 病变的局部治疗上，而关于姑息治疗中恶性 IVC 综合征导致的完全髂股静脉重建的报告有限。在本病例报告中，我们描述了 1 例广泛恶性压迫和侵犯髂股静脉系统的患者的临床表现、技术方法和症状结果。一名 82 岁的男性患有转移性肺癌，侵犯上腹部右侧，出现阴囊和双侧下肢水肿以及全身性水肿。计算机断层扫描（CT）显示右侧肾上腺有 11 厘米的转移灶和广泛的腹膜后淋巴结病，导致 IVC 和髂静脉受压。股静脉造影显示广泛的侧支静脉途径形成，腰背部和椎骨静脉显影，此外还有椎骨/骶骨静脉丛。使用专门的静脉支架进行髂股静脉重建。本病例报告强调了在弥漫性转移性疾病导致 IVC 受压和综合征的复杂姑息治疗患者中，进行技术上成功的完全髂股静脉重建。
