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3. [Massive obstruction of venous return due to a primary inferior vena cava tumour]

Author

Belén Viñals Larruga, Fernando Carbonell Castelló, Rafael Garcia Espinosa, and M. Eugenia Gómez García

Subjects
Leiomyosarcoma, Male, medicine.medical_specialty, medicine.medical_treatment, Vena Cava, Inferior, Inferior vena cava, Severity of Illness Index, Laparotomy, medicine, Humans, Angiosarcoma, Tricuspid valve, business.industry, General Engineering, Middle Aged, medicine.disease, Thrombosis, Vascular Neoplasms, medicine.anatomical_structure, medicine.vein, cardiovascular system, Radiology, Differential diagnosis, business, Venous return curve
Abstract

A 62-year-old patient was studied after an episode of fainting with oppressive pain that appeared and recurred during exercise. Abdominal-pelvic CT revealed a heterogeneous retroperitoneal mass from the infrarenal distal third of the inferior vena cava (IVC) with calcifications that was highly vascularized, partially extraand endoluminal, with cranial extension up to the right auricle, that was implanted in the septum and up to the tricuspid valve to the RV (Figs. 1 and 2). Given the obstruction of the IVC and the existence of collateral venous return, and considering the differential diagnosis between leiomyosarcoma and angiosarcoma with associated thrombosis, surgery was performed and the IVC was resected in 2 stages using laparotomy and sternotomy. Final pathology diagnosis: high-grade leiomyosarcoma. c i r e s p . 2 0 1 3 ; 9 1 ( 3 ) : e 1 7

Published
2012

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