Superior vena cava syndrome due to a leiomyosarcoma of the anterior mediastinum: a case report and literature overview
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2014
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Facultad/escuela
Idioma
en
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Elsevier Ltd
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Atribution 4.0 International (CC BY 4.0)
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https://creativecommons.org/licenses/by/4.0/deed.es
Resumen
INTRODUCTION: Leiomyosarcomas are an infrequent cause of malignant superior vena cava syndrome
(VCS).
PRESENTATION OF CASE: A 51-year old male patient was admitted for a three-day history of dyspnoea,
dysphagia and erythema of the head and neck. Computed tomography and magnetic resonance imaging
showed a lesion arising on the anterior mediastinum, which was in close proximity with a thrombus in
the superior vena cava. Surgical excision was performed, including open resection of the primary tumour
and an atrio-innominate vein bypass with 8-mm polytetrafluoroethylene (PTFE). Histology confirmed a
leiomyosarcoma and postoperative radiotherapy sessions were performed. Due to evidence of enlarge ment of the thrombus, a second intervention was undertaken. In this procedure, a remainder of the
primary tumour was resected and the superior vena cava reconstructed with an autologous pericardium
patch. The patient recovered satisfactorily and was discharged on the seventh postoperative day, with
no evidence for relapse after 10 months of follow-up.
DISCUSSION: Leiomyosarcomas comprise less than 2% of the tumours of the mediastinum and are a rare
cause of paraneoplastic VCS. Male patients in their sixties are most commonly affected. Relapses seem
to be common, and thus a careful follow-up is often recommended.
CONCLUSION: In spite of the limited data on the management of thoracic leiomyosarcomas, surgery is
currently considered the mainstay of treatment.
© 2014 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd. This is an open
access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
Notas
Indexación Scopus.
Palabras clave
Superior Vena Cava Syndrome, Leiomyosarcoma, Vascular Neoplasms
Citación
International Journal of Surgery Case Reports. Volume 5, Issue 12, Pages 984 - 987. 2014
DOI
10.1016/j.ijscr.2014.10.036