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[Leiomyosarcoma Originating from the Renal Vein-A Case Report].

Akiko Nakazawa1, Kei Shimada, Toshio Kumasaka

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Gan to Kagaku Ryoho. Cancer & Chemotherapy
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Summary

A rare renal vein leiomyosarcoma was successfully resected in an 83-year-old female. This vascular sarcoma case highlights successful surgical management and a positive 1-year follow-up, free from recurrence or metastasis.

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Area of Science:

  • Oncology
  • Vascular Surgery
  • Pathology

Background:

  • Leiomyosarcoma is a rare soft tissue sarcoma, with vascular origin being particularly uncommon.
  • Renal vein leiomyosarcoma is a rare subtype, distinct from more common inferior vena cava origins.
  • This case presents a diagnostic and surgical challenge due to the tumor's location and infiltration.

Purpose of the Study:

  • To report a rare case of leiomyosarcoma originating from the renal vein.
  • To describe the diagnostic imaging and histopathological findings.
  • To highlight the successful surgical management and outcomes of this rare vascular tumor.

Main Methods:

  • Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) for tumor characterization.
  • Surgical resection including left renal and retroperitoneal tumor resection.
  • Histopathological examination and immunohistochemical staining (α-SMA, desmin) for diagnosis.

Main Results:

  • Imaging revealed an irregular 7 cm mass at the left renal hilum with central necrosis, infiltrating the renal pelvis and ureter.
  • Histopathology confirmed leiomyosarcoma with spindle and polyrhomboidal cells, continuous with the renal vein wall.
  • Immunohistochemistry showed positivity for α-SMA and weak positivity for desmin.
  • The patient remained disease-free with no recurrence or metastasis at 1-year post-surgery.

Conclusions:

  • Renal vein leiomyosarcoma is a rare entity requiring a high index of suspicion.
  • Multimodal imaging and detailed histopathology are crucial for diagnosis.
  • Complete surgical resection offers a favorable prognosis, even in rare vascular sarcoma cases.