Primary leiomyosarcoma of the inferior vena cava: How should it be treated and the vein anatomy re-established?

Retroperitoneal sarcomas are responsible for 10-15% of all sarcomas in soft tissue. Leiomyosarcoma of the inferior vena cava has a slow growth rate, and the initial symptoms are related to the affected segment of the vein. A 56-year-old woman with leiomyosarcoma of the middle segment of the inferior vena cava underwent en-block resection of the affected segment of the vena cava and the right kidney. The inferior segment of the vena cava was tied, and the superior segment was anastomosed to the left renal vein using a polyester prosthesis. The patient was followed for 14 months and did not present any postoperative intercurrence. In conclusion, the leiomyosarcoma is a rare tumor that should be surgically treated with wide margin resections in order to prevent relapses.