Concomitant Aorto-Caval Reconstruction for Inferior Vena Cava Leiomyosarcoma

Area of Science:

• Vascular Surgery
• Surgical Oncology
• Medical Imaging

Background:

• Inferior vena cava (IVC) leiomyosarcoma is a rare smooth muscle neoplasm.
• Surgical resection is the standard treatment for nonmetastatic disease, often requiring vascular reconstruction.

Observation:

• A 63-year-old man presented with back pain and was diagnosed with IVC leiomyosarcoma.
• The tumor involved both the IVC and infrarenal abdominal aorta, necessitating combined aorto-caval reconstruction.

Findings:

• The patient underwent en-bloc tumor resection with aorta reconstruction followed by IVC reconstruction using veno-venous bypass.
• Postoperative recovery was uncomplicated, with no significant tumor burden at one year and patent bypass grafts.

Implications:

• Concurrent aorto-caval reconstruction is a viable option for IVC leiomyosarcoma with aortic involvement in suitable candidates.
• Veno-venous bypass is a valuable technique for complex oncologic resections.
• Interdisciplinary collaboration enhances outcomes for challenging vascular pathologies.