Management of leiomyosarcoma of the IVC, a rare vascular tumour, treated with adjuvant radiation therapy in a tertiary care hospital in India

Preeti Belani; Sumit Basu; Harshavardhan  Bhosale; Shaju  Pilakkal; Asmita Doiphode; Rajesh Mistry; Vidyadhar Lad; Somnath Chattopadhyay; Bijal Kulkarni

doi:10.18203/2320-6012.ijrms20252047

Authors

Preeti Belani Department of Radiation Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Sumit Basu Department of Radiation Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Harshavardhan Bhosale Department of Radiation Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Shaju Pilakkal Department of Medical Physics, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Asmita Doiphode Department of Medical Physics, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Rajesh Mistry Department of Surgical Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Vidyadhar Lad Department of Cardiac surgery and Heart Transplant, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Somnath Chattopadhyay Department of Hepato-Pancreato-Biliary Surgery and Liver Transplant, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
Bijal Kulkarni Department of Histopathology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252047

Keywords:

Leiomyosarcoma, Inferior vena cava leiomyosarcoma, Rare vascular malignancy, Rare malignancies, Inferior vena cava tumor

Abstract

Leiomyosarcoma of the inferior vena cava (IVC) is an extremely rare malignancy, in an already rare subgroup of primary vascular malignancies, with nonspecific clinical presentation. The primary treatment modality is surgery and the disease outcome is dismal even after complete surgical resection. The role of adjuvant treatment (including Chemotherapy and Radiotherapy) is now being routinely considered. In this study, we have discussed a case of a 50 years old lady with good performance status, diagnosed with Leiomyosarcoma of the IVC. She was found to have a positive margin after extensive surgery and was treated with adjuvant External beam radiation therapy using VMAT technique in 2 phases. At 3 months after completing radiation treatment, her PET CT scan showed no evidence of disease and at 4 months follow up, she had good performance status with no major complaints. However, 5 months after completing treatment, she developed multiple liver metastases.

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References

Ducimetière F, Lurkin A, Ranchère-Vince D.: Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PloS one. 2011;3:20294. DOI: https://doi.org/10.1371/journal.pone.0020294

Menon G, Mangla A, Yadav U. Leiomyosarcoma. In. StatPearls, Treasure Island (FL). 2024.

Mingoli A, Cavallaro A, Sapienza P, Di Marzo L, Feldhaus RJ, Cavallari N. International registry of inferior vena cava leiomyosarcoma: analysis of a world series on 218 patients. Anticancer Res. 1996;16:3201-5.

Alkhalili E, Greenbaum A, Langsfeld M, Marek J, Rana MA, Glew R, et al. Leiomyosarcoma of the inferior vena cava: a case series and review of the literature. Ann Vasc Surg. 2016;33:245-51. DOI: https://doi.org/10.1016/j.avsg.2015.10.016

Bisello S, Cilla S, Benini A. Dose-volume constraints for organs. At risk in radiotherapy (CORSAIR): an “All-in-One” multicenter-multidisciplinary practical summary. Current Oncol. 2022;27:7021-50. DOI: https://doi.org/10.3390/curroncol29100552

Wang MX, Menias CO, Elsherif SB, Segaran N, Ganeshan D: Current update on IVC leiomyosarcoma. Abdom Radiol. 2021;46:5284-96. DOI: https://doi.org/10.1007/s00261-021-03256-9

Kulaylat MN, Karakousis CP, Doerr RJ, Karamanoukian HL, O'Brien J, Peer R. Leiomyosarcoma of the inferior vena cava: a clinicopathologic review and report of three cases. J Surg Oncol. 1997;65:205-17. DOI: https://doi.org/10.1002/(SICI)1096-9098(199707)65:3<205::AID-JSO11>3.0.CO;2-2

Al-Otaibi HS, Ahmed MH, Abdul RGN. Leiomyosarcoma of the inferior vena cava presenting as a renal mass: a case report. Int J Oncol Res. 2012;5:45-10.

Hollenbeck ST, Grobmyer SR, Kent KC, Brennan MF: Surgical treatment and outcomes of patients with primary inferior vena cava leiomyosarcoma. J American Coll Surg. 20031;197:575-9. DOI: https://doi.org/10.1016/S1072-7515(03)00433-2

Kieffer E, Alaoui M, Piette JC, Cacoub P, Chiche L. Leiomyosarcoma of the inferior vena cava: experience in 22 cases. Ann Surg. 2006;2:289-95. DOI: https://doi.org/10.1097/01.sla.0000229964.71743.db

Bednarova I, Frellesen C, Roman A, Vogl TJ. Case 257: leiomyosarcoma of the inferior vena cava. Radiol. 2018;288:901-8. DOI: https://doi.org/10.1148/radiol.2018160821

Mu D, Wang D, Zhou K, Zhu B. Radiographic features of intraluminal leiomyosarcoma of the inferior vena cava: an atypical case report. Abdom Imag. 2011;36:586-9. DOI: https://doi.org/10.1007/s00261-010-9673-x

Narata M, Okuhata Y, Abe K, Takemoto A, Maebayashi T, Furuhashi S, et al. Primary leiomyosarcoma of the inferior vena cava: case report. Abdom Imag. 2010;35:481-4. DOI: https://doi.org/10.1007/s00261-009-9549-0

Young WK, Shah SA, Feller ER. Budd-Chiari Syndrome Due to Inferior Vena Cava Obstruction by Leiomyosarcoma: 884. Official J American Coll Gastroenterol. 2006;1:353-4. DOI: https://doi.org/10.14309/00000434-200609001-00884

Ganeshalingam S, Rajeswaran G, Jones RL, Thway K, Moskovic E. Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging. Clin Radiol. 2011;66:50-6. DOI: https://doi.org/10.1016/j.crad.2010.08.004

Zhou X, Wang M, Li S. A case of a huge inferior vena cava leiomyosarcoma: Precise preoperative evaluation with Gadobutrol-enhanced MRI. Cancer Manag Res. 2020;31:7929-39. DOI: https://doi.org/10.2147/CMAR.S258990

Singh N, Shivdasani D, Karangutkar S. Rare case of primary inferior vena cava leiomyosarcoma on F-18 fluorodeoxyglucose positron emission tomography-computed tomography scan: Differentiation from nontumor thrombus in a background of procoagulant state. Indian J Nucl Med. 2014;1:29:246-8. DOI: https://doi.org/10.4103/0972-3919.142629

MacDowell CJ, Berezovsky D, Kumar P, Kim V, Livshits I, Kang F. Transvenous biopsy of inferior vena cava leiomyosarcoma: two case reports. Radiol Case Rep. 2024;19:1128-35. DOI: https://doi.org/10.1016/j.radcr.2023.12.013

Abisi S, Morris-Stiff GJ, Scott-Coombes D, Williams IM, Douglas-Jones AG, Puntis MC. Leiomyosarcoma of the inferior vena cava: clinical experience with four cases. World J Surg Oncol. 2006;4:1-6. DOI: https://doi.org/10.1186/1477-7819-4-1

Mangla A, Yadav U. Cancer, Leiomyosarcoma. StatPearls. 2020.

Gama JM, Almeida R, Oliveira RC, Casanova J. When vessels and sarcomas combine: a review of the inferior vena cava leiomyosarcoma. J Vascular Dis. 2024;8:34-48. DOI: https://doi.org/10.3390/jvd3010003

Hines OJ, Nelson S, Quinones‐Baldrich WJ, Eilber FR. Leiomyosarcoma of the inferior vena cava: prognosis and comparison with leiomyosarcoma of other anatomic sites. Cancer. 1999;85:1077-83. DOI: https://doi.org/10.1002/(SICI)1097-0142(19990301)85:5<1077::AID-CNCR10>3.0.CO;2-0

Rusu CB, Gorbatâi L, Szatmari L.: Leiomyosarcoma of the inferior vena cava. Our experience and a review of the literature. Romanian J Morphol Embryol. 2020;61:227. DOI: https://doi.org/10.47162/RJME.61.1.25

Graves A, Longoria J, Graves G, Ianiro C. Leiomyosarcoma of the inferior vena cava: a case report. J Surg Case Rep. 2020;6:479. DOI: https://doi.org/10.1093/jscr/rjaa479

Rosenbaum PC, da Silva Boigues AH, Tassone FZ. A rare case of leiomyosarcoma of the inferior vena cava in a 32‐year‐old patient. Prec Rad Oncol. 2021;5:115-8. DOI: https://doi.org/10.1002/pro6.1118

Mahmoud AB, Yakoubi C, Kacem S, Sebai A, Daghfous A, Kacem M. Inferior vena cava resection for a leiomyosarcoma: A case report. International J Surg Case Rep. 2023;106:108304. DOI: https://doi.org/10.1016/j.ijscr.2023.108304

Dzsinich C, Gloviczki P, Heerden JA. Primary venous leiomyosarcoma: a rare but lethal disease. J Vasc Surg. 1992;15:595-603. DOI: https://doi.org/10.1016/0741-5214(92)90003-Q

Reddy VP, Van Veldhuizen PJ, Muehlebach GF. Leiomyosarcoma of the inferior vena cava: a case report and review of the literature. Cases J. 2010;3:1-5. DOI: https://doi.org/10.1186/1757-1626-3-71

Yoshizawa K, Ohno Y, Kurata T, Takagi Y, Kasai T, Takizawa M, et al. Primary leiomyosarcoma of the inferior vena cava in a pediatric case: a case report and literature review. Surg Case Rep. 2023;6:52. DOI: https://doi.org/10.1186/s40792-023-01630-x

Kim JT, Kwon T, Cho Y, Shin S, Lee S, Moon D: Multidisciplinary treatment and long-term outcomes in six patients with leiomyosarcoma of the inferior vena cava. J Korean Surg Soc. 2012;82:101. DOI: https://doi.org/10.4174/jkss.2012.82.2.101

Dew J, Hansen K, Hammon J, McCoy T, Levine EA, Shen P. Leiomyosarcoma of the inferior vena cava: surgical management and clinical results. The American Surg. 2005;71:497-501. DOI: https://doi.org/10.1177/000313480507100609

Hardwigsen J, Balandraud P, Ananian P, Saïsse J, Le Treut YP: Leiomyosarcoma of the retrohepatic portion of the inferior vena cava: clinical presentation and surgical management in five patients. J American Coll Surg. 2005;200:57-63. DOI: https://doi.org/10.1016/j.jamcollsurg.2004.09.035

Munene G, Mack LA, Moore RD, Temple WJ. Neoadjuvant radiotherapy and reconstruction using autologous vein graft for the treatment of inferior vena cava leiomyosarcoma. J Surg Oncol. 2011;103:175-8. DOI: https://doi.org/10.1002/jso.21798