Abstract
We present herein the case of a 53-year-old woman who underwent successful surgical treatment for a leiomyosarcoma of the liver that originated from the posterior hepatic segment and involved the retrohepatic inferior vena cava (IVC). A computed tomographic scan and magnetic resonance imaging demonstrated a large tumor, with rich vascularity, in the liver. The IVC was found to be occluded on these scans, which was confirmed by venacavography. The patient underwent a combined right hepatic and caval resection with reconstruction using an expanded polytetra-fluoroethylene graft. The tumor consisted of spindle-shaped cells with cigar-shaped nuclei. It also had a moderate degree of cellularity and ten mitotic figures per ten high-power fields. Immunohistologically, desmin and alpha-smooth muscle actin were stained positive in the tumor cells, implying that the tumor was derived from smooth muscle cells. The patient is alive and well 15 months after her operation.
Similar content being viewed by others
References
Craig JR, Petes RL, Edmondson HA (1989) In: Hartmann WH, Sobin LH (eds) Tumors of the liver and intrahepatic bile ducts. Armed Forces Institute of Pathology, Washington DC, pp 1–7
Subramanyam BR, Balthazar EJ, Hilton S, Lefleur RS, Horii SC, Raghavendra BN (1984) Hepatocellular carcinoma with venous invasion. Radiology 150:793–796
Kumada K, Shimahara Y, Fukui K, Itoh K, Morikawa K, Ozawa K (1988) Extended right hepatic lobectomy: combined resection of inferior vena cava and its reconstruction by ePTFE graft. Acta Chir Scand 154:481–483
Miller CM, Schwartz ME, Nishizaki T (1991) Combined hepatic and vena caval resection with autogenous caval graft replacement. Arch Surg 126:106–108
Huguet C, Ferri M, Gavelli A (1995) Resection of the suprarenal inferior vena cava. Arch Surg 130:793–797
Clayman RV, Gonzalez R, Fraley EE (1980) Renal cell cancer invading the inferior vena cava: clinical review and anatomical approach. J Urol 123:157–163
Herring M, Gardner A, Peigh P (1984) Patency on canine inferior vena cava grafting: effects of graft material, site, and endothelial seeding. J Vasc Surg 1:877–887
Smith D, Hammon J, Anane-Sefah R, Richardson R, Trimble C (1975) Segmental venous replacement: a comparison of biological and synthetic substitutes. J Thorac Cardiovasc Surg 69:589–598
Ishak KG (1976) Mesenchymal tumors of the liver. In: Okuda K, Peters RL (eds) Hepatocellular carcinoma. Wiley, New York, pp 268–275
Maki HS, Hubert BC, Sajjad SM, Kirchner JP, Kuehner ME (1987) Primary hepatic leiomyosarcoma. Arch Surg 122:1193–1196
Gates LK, Cameron AJ, Nagorney DM, Goellner JR, Farley DR (1995) Primary leiomyosarcoma of the liver mimicking liver abscess. Am J Gastroentelol 90:649–652
MacMahon HE, Ball HG (1971) Leiomyosarcoma of hepatic vein and the Budd-Chiari syndrome. Gastroenterology 61:239–243
Watanabe K, Saito A, Wakabayashi H, Kawaguchi T, Suzuki T (1991) Two autopsy cases of primary leiomyosarcoma of the liver. Acta Pathol Japan 41:461–465
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Enoki, T., Hayashi, D., Inokuchi, T. et al. Combined right hepatic and retrohepatic caval resection with reconstruction using a polytetrafluoroethylene graft for primary leiomyosarcoma of the liver: Report of case. Surg Today 29, 67–70 (1999). https://doi.org/10.1007/BF02482973
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482973