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Year : 2014  |  Volume : 4  |  Issue : 2  |  Page : 121-123

Primary leiomyosarcoma of the inferior vena cava invading the kidney

1 Department of Urology, K.E.M. Hospital, Parel, Mumbai, Maharashtra, India
2 Y.C.M. Hospital, Pimpri, Maharashtra, India

Correspondence Address:
Ajaykumar R Gajengi
Department of Urology, M.S. Building, 8th Floor, K.E.M. Hospital, Parel, Mumbai - 400 012, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-9596.143093

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Leiomyosarcomas of the inferior vena cava (IVC) with direct invasion of the kidney without involvement of renal vein is rare. A 33-year-old male presented with right flank pain. Contrast enhanced computed tomogram (CT) of the abdomen showed 8.3 cm × 7.5 cm × 5.7 cm vascular mass arising from the suprarenal and hepatic segment of IVC. The IVC was partly occluded by the mass, which was invading right adrenal gland and kidney with normal renal vein. CT guided biopsy revealed low grade leiomyosarcoma. Smooth muscle actin and desmin were positive while S-100, CD34 and C-KIT negative. The patient underwent excision of IVC leiomyosarcoma and right nephrectomy with reconstruction of IVC using saphenous vein and right renal vein graft. Histopathological examination revealed high grade spindle cell sarcoma. Postoperatively, patient received radiation therapy. Patient remained disease free for 2 years after treatment. Surgery remains the primary modality of treatment, whereas the role of chemotherapy and radiotherapy, either as a primary modality or as an adjuvant, remains to be proven. Some recent reports claim promising results, but randomized trials do not exists considering the rarity of this disease.

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