Leiomyosarcoma of the Adrenal vein: a novel approach to surgical resectionReportar como inadecuado




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World Journal of Surgical Oncology

, 5:109

First Online: 03 October 2007Received: 12 April 2007Accepted: 03 October 2007

Abstract

BackgroundLeiomyosarcomas typically originate within smooth muscle cells. Leiomyosarcomas arising from the adrenal vein are rare malignancies associated with delayed diagnosis and poor prognosis. The most common vascular site of origin is the inferior vena cava.

Case presentationThis is a 64-year old woman who presented with a 13 × 6.5 × 6.6 cm heterogeneous mass arising in the region of the right adrenal gland and extending into the inferior vena cava IVC and the right atrium. Biochemical evaluation excluded a functional tumor of the adrenal gland, and multiple tumor markers were negative. We present the novel use of deep hypothermic circulatory arrest DHCA in the resection of an adrenal vein leiomyosarcoma extending into the right atrium. The patient remains free of disease ten months after surgery. DHCA afforded a bloodless operative field for optimal resection of disease from within the IVC.

ConclusionThe diagnosis of leiomyosarcomas of the adrenal vein is one of exclusion and involves preoperative radiological imaging and biochemical evaluation to exclude other functional tumors of the adrenal gland. Aggressive surgical resection is associated with improved survival and may be best achieved via collaboration among different surgical subspecialties.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-5-109 contains supplementary material, which is available to authorized users.

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Autor: Tracy S Wang - Idris Tolgay Ocal - Ronald R Salem - John Elefteriades - Julie A Sosa

Fuente: https://link.springer.com/







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