Combined right hepatic and retrohepatic caval resection with reconstruction using a polytetrafluoroethylene graft for primary leiomyosarcoma of the liver: report of case.

We present herein the case of a 53-year-old woman who underwent successful surgical treatment for a leiomyosarcoma of the liver that originated from the posterior hepatic segment and involved the retrohepatic inferior vena cava (IVC). A computed tomographic scan and magnetic resonance imaging demonstrated a large tumor, with rich vascularity, in the liver. The IVC was found to be occluded on these scans, which was confirmed by venacavography. The patient underwent a combined right hepatic and caval resection with reconstruction using an expanded polytetrafluoroethylene graft. The tumor consisted of spindle-shaped cells with cigar-shaped nuclei. It also had a moderate degree of cellularity and ten mitotic figures per ten high-power fields. Immunohistologically, desmin and alpha-smooth muscle actin were stained positive in the tumor cells, implying that the tumor was derived from smooth muscle cells. The patient is alive and well 15 months after her operation.