Inferior venacaval reconstruction with bovine pericardium, re-implantation of renal veins and right hepatectomy in a patient with recurrent venous leiomyosarcoma

Abstract

Management of patients with venous leiomyosarcomas is difficult because of multiple reasons. In most patients symptoms occur late, adjuvant therapy is hardly effective, and surgical resection with caval replacement is a major operation with unpredictable long-term benefit. Our patient with type II leiomyosarcoma underwent Inferior Vena Cava (IVC) resection and reconstruction with a “neo IVC” fashioned out of bovine pericardial patch. In addition, she required reimplantation of both renal veins to the neo IVC, right hepatectomy and cholecystectomy. The specific venous perfusion strategies employed because of the juxta renal location of tumor and the use of bovine pericardium for IVC reconstruction are discussed.