Ressecção cirúrgica de leiomiossarcoma de veia cava inferior retro-hepática sem reconstrução vascular: relato de caso
Surgical resection of retrohepatic inferior vena cava leiomyosarcoma without vascular reconstruction: case report
Ian Freire Castro; Paulo Henrique Silva Nunes; Ana Camila Xavier Lopes; Mariana Coelho Lima; Régis Ponte Conrado; Renato Mazon Lima Verde Leal; Annya Costa Araújo de Macedo Goes; Marcelo Leite Vieira Costa
Resumo
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Abstract
Inferior vena cava leiomyosarcoma (IVCL) is a rare malignant mesenchymal tumor. Surgical treatment is a challenge because it must combine free surgical margins with vascular reconstruction, using prosthetic or autologous grafts, primary suture, or simple ligation without vein reconstruction. The ligation option is possible thanks to the slow growth of the tumor, allowing collateral venous circulation to develop. We present a case of an IVCL treated with radical resection without vascular reconstruction. The patient was a 48-year-old female with abdominal pain in the right upper quadrant, asthenia, and postprandial dyspeptic symptoms. Abdominal tomography revealed a mass with an expansive formation located in the infrahepatic segment of the inferior vena cava and reduced vessel lumen. During surgery, vein clamping did not provoke hemodynamic repercussions, suggesting sufficient collateral circulation formation. It was decided to perform a radical resection of the entire portion of the retrohepatic vena cava and ligate the vena cava without vascular reconstruction. The patient recovered without complications.
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Referências
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Submetido em:
10/08/2022
Aceito em:
31/10/2022
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