Lieomyosarcoma of the IVC(Inferior Vena Cava)

Tumors of the blood vessels are very rare so to speak.Still rarer is their diagnosis and therefore treatment options and guidelines regarding their management are still evolving.We report to you a similar case that was operated in our setup in chandigarh until recently.

    This man aged 66 years reported to our hospital with large mass abdomen and was not able to eat or drink as he used to vomit out whatever he took orally.Added to it was a recent onset of swelling in both his lower limbs.He went to different hospitals of repute including two regional reputed medical schools which denied him surgery saying he would die on table.This guy almost resigned to his fate till someone suggested him to see us in our centre in chandigarh.

   Seeing his CT scan we realized he either has a retroperitoneal mass impinging his Inferior Vena Cava (main blood vessel of the body that carries blood back to the heart) or else it’s a tumour arising from the Ivc itself.

We took up the challenge of operating him as we were inclined to give him a new lease of life.Surgery lasted for almost like six hours and we were able to excise the whole mass .Ivc was removed enbloc with the tumour and almost 20 cms of Ivc was replaced with 14 mm PTFE graft.To be honest with you operating on the Ivc is no easy job as the vessel usually is thin walled and becomes more friable in the setting of an underlying pathology as was in this case.Anyways we don’t accept failures and that is what made us come out victorious.

      During the writing of this article ,the concerned patient is recuperating in the hospital and would be discharged in a couple of days from now on.

Few cases(less than 5) have been operated in India but none has replaced Ivc with a graft for obvious reasons as stated.

The take home message is not to be disheartened in life for there always is light at the end of the tunnel.