gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Retroperitoneal leiomyosarcoma (RLS) of the inferior vena cava (VCI): A interdisciplinary challenge - Case report and review of the literature

Meeting Abstract

  • corresponding author presenting/speaker Christian Schneider - Klinikum Grosshadern der Ludwig-Maximilans-Universität, München, Deutschland
  • Christian Graeb - Klinikum Grosshadern der Ludwig-Maximilans-Universität, München
  • Martin K. Angele - Klinikum Grosshadern der Ludwig-Maximilans-Universität, München
  • Karl-Walter Jauch - Klinikum Grosshadern der Ludwig-Maximilans-Universität, München
  • Christiane Bruns - Klinikum Grosshadern der Ludwig-Maximilans-Universität, München

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO403

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Schneider et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



RLS’s of vascular origin are diagnosed rarely and they mostly reach a considerable size at time of diagnosis. RLS’s of vascular origin as well as tumor infiltration of vessels by RLS’s have been demonstrated in 25 % of all published cases. The denoted 5-year and 10-year overall survival is 33 and 49% respectively. Tumour-free resection margins have been shown to represent the most important prognostic factor. The required en-bloc-resection mostly turns out to be difficult due to extensive tumour size and involvement of other organs. Therefore, multidisciplinary therapeutic strategies are demanded.

Methods: Diagnostic and therapeutic properties of RLS will be presented referring a case report of a 61-year old woman diagnosed with a RLS infiltrating the sub-hepatic inferior vena cava (VCI). In addition, earlier surgical interventions in RLS in our hospital will be discussed based on this case report and faced up to current international literature.

Casuistic: A 61 year old woman was introduced in our hospital due to unspecific abdominal pain. The following extensive diagnostic interventions revealed a large retroperitoneal hyper-vascular tumour in right upper abdomen with infiltration of the sub-hepatic VCI. An en-bloc-resection including the right kidney and parts of the VCI was performed after selective tumour vessel occlusion via angiographic embolisation. The surgical intervention was performed in accordance to generally accepted standards and a 16 mm prosthesis was interposed after resection of the sub-hepatic VCI. The immunohistopathological analysis revealed a leiomyosacoma, G3 graded. VCI as place of origin could finally not be proven in the histopathological analysis. Thereafter, the patient received an adjuvant chemotherapy according the EIA protocol. The chemotherapy was discontinued due to serious side effects after three cycles of chemotherapy. Six month after the surgery the patient developed multiple lung metastases. In the year 2004, altogether 97 surgical interventions were performed with the diagnosis sarcoma of variable localisation and differentiation in our hospital. 32% of the removed sarcomas were localized intra-abdominal and 22% of those were classified as leiomyosarcoma by histopathology. Most of the surgical interventions were accomplished due to local recurrence of the sarcoma. Furthermore, one third of the surgical interventions were carried out as multi-visceral resections and VCI interposition with vessel prosthesis was necessary in only one case. Until now, almost 300 case reports of leiomyosarcoma with involvement of the VCI were reported in the literature. It still remains unclear whether RLS and tumours of the deep retroperitoneum are neoplasm of vascular origin. Comprehensive diagnostic approaches and possible radiological interventions preoperatively are demanded to ameliorate the rate of R0 resection.