Infra-hepatic caval resection en bloc with right nephrectomy followed by caval reconstruction for locally advanced caval leiomyosarcoma: A case report and literature review

Brasoveanu,Vladislav; Barbu,Ion; Balescu,Irina; Bacalbasa,Nicolae; Cordos,Ioan

doi:10.3892/etm.2021.10812

Infra-hepatic caval resection en bloc with right nephrectomy followed by caval reconstruction for locally advanced caval leiomyosarcoma: A case report and literature review

Authors:
- Vladislav Brasoveanu
- Ion Barbu
- Irina Balescu
- Nicolae Bacalbasa
- Ioan Cordos
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Affiliations: Department of Visceral Surgery, ‘Dan Setlacec’ Center of Gastrointestinal Diseases and Liver Transplantation, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania, Department of Surgery, ‘Ponderas’ Academic Hospital, 021188 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Thoracic Surgery, ‘Marius Nasta’ National Institute of Pneumology, 050159 Bucharest, Romania
Published online on: September 28, 2021 https://doi.org/10.3892/etm.2021.10812
Article Number: 1377

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Abstract

Retroperitoneal sarcomas often require complex surgical procedures in order to achieve complete resection; in such cases both vascular and visceral resections are needed. When it comes to the need for vascular reconstruction, the type of graft as well as the type of reconstructive process are chosen according to the length and location of the resected segment. Meanwhile, depending on the location of the resected segment, other vascular reconstructions may be needed such as the reimplantation of the renal veins. However, in certain cases, this reimplantation is not mandatory, an adequate renal outflow being reported through the collateral network at this level. We present the case of a 43‑year‑old patient diagnosed with a large retroperitoneal sarcoma originating from the cava vein invading the right kidney. Resection of the tumor was performed en bloc with caval resection and right nephrectomy, without reimplantation of the left renal vein at the level of the graft. Extended visceral and vascular resections might be needed in order to achieve complete resection of inferior cava vein sarcomas; re‑implantation of the left renal vein being not mandatory if rich collateral circulation is present.

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