Abstract
Introduction: Vascular malformations are anomalies of the vascular system, constituted by a network of vessels with mature endothelium, with normal cell replacement without proliferation capacity. Case Report: We report the clinical case of a 25-year-old man who came to the hospital for left pelvic limb edema and lumbar pain. An ultrasonography (USG) and positron emission tomography-computed tomography (PET-CT) revealed deep vein thrombosis of the inferior vena cava (IVC) and left iliac vein and a 9.5 cm × 5 cm retroperitoneal nometabolic tumor compatible with perivascular lymphadenopathies. Exploratory laparotomy was performed, transperitoneum exploration of the retroperitoneum and resection of the tumor arising from the IVC and left iliac vein. Pathological examination revealed a 10 cm retroperitoneal tumor filled with venous vessels and fibrotic septa. Postoperative diagnosis was venous malformation of the IVC. Conclusion: Cavernous hemangiomas are not true vascular tumors, but rather a congenital vascular anomaly. It is classified by International Society for the Study of Vascular Anomalies as venous malformation. This tumor is present from birth, and it grows with the child, they do not involute spontaneously. A differential diagnosis of vena cava tumors is leiomyosarcoma. This is the first case in literature of a vascular malformation (formerly called cavernous hemangioma) involving the IVC. It is important to know that this benign pathology has an excellent prognosis and survival after a successful surgery.
Highlights
Vascular malformations are anomalies of the vascular system, constituted by a network of vessels with mature endothelium, with normal cell replacement without proliferation capacity
A differential diagnosis of vena cava tumors is leiomyosarcoma. This is the first case in literature of a vascular malformation involving the inferior vena cava (IVC)
They are present from birth and grow together with the patient, unlike the hemangiomas they do not involute spontaneously; these venous malformations (VM) are still wrongly named cavernous hemangiomas [1]
Summary
Vascular malformations are anomalies of the vascular system, constituted by a network of vessels with mature endothelium, with normal cell replacement without proliferation capacity. We are reporting a clinical case of a 25-year-old male He came to the hospital with a history of three weeks prior admission with intermittent lumbar pain, and a 24 hour left limb increased in volume and pain (Figure 1). Exploratory laparotomy was performed a transperitoneal approach to the retroperitoneum, left medial visceral rotation of the sigmoid was made, to expose the mass and veins, the lesion was identified arising from the IVC (Figure 3A). It was entirely resected, and the veins were repaired with vascular suture, no implant needed (Figure 3B, C).
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