Surgical management of vena cava sarcoma: a technical challenge

Autores de IIS La Fe

• Andrea Boscà Robledo

  Autor

• Cristina Ballester Ibáñez

  Autor

• Rafael López Andújar

  Autor

Participantes ajenos a IIS La Fe

• Guerrero-Antolino P.

Grupos

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Abstract

Inferior vena cava (IVC) sarcomas are rare, aggressive tumours with a poor prognosis. Surgical resection is the only potentially curative treatment, but it can be challenging due to extensive tumour involvement and associated complications. We present the case of a woman in her 30s diagnosed with a retroperitoneal mass infiltrating the IVC, liver and diaphragm. Biopsy confirmed the diagnosis of locally advanced IVC leiomyosarcoma. The patient underwent neoadjuvant chemotherapy and radiotherapy, followed by surgical resection of the tumour, the involved organs and a segment of the IVC. Vascular reconstruction was performed using a cadaver vein graft. Despite the aggressive nature of IVC sarcomas and the challenges associated with their management, surgical resection remains the primary goal. Long-term follow-up is crucial for monitoring recurrence, which is common in these patients. © BMJ Publishing Group Limited 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

Keywords

• Adult; Female; Humans; Leiomyosarcoma; Neoadjuvant Therapy; Retroperitoneal Neoplasms; Sarcoma; Tomography, X-Ray Computed; Vascular Neoplasms; Vena Cava, Inferior; abdominal cavity; adult; Article; asthenia; body weight loss; cadaver; cancer radiotherapy; case report; cava vein; cell proliferation; clinical article; CT guided biopsy; differential diagnosis; female; flank pain; follow up; human; inferior cava vein; leiomyosarcoma; neoadjuvant chemotherapy; prognosis; renal artery; sarcoma; superior mesenteric artery; thrombosis; tumor volume; ultrasound; vein graft; vena cava sarcoma; x-ray computed tomography; inferior cava vein; leiomyosarcoma; neoadjuvant therapy; pathology; procedures; retroperitoneal tumor; sarcoma; surgery; vascular tumor