Vena Cava and Pancreatic head En Bloc Resection for an Invasive Inferior Vena Cava Leiomyosarcoma in a Liver Transplant Patient - 11/11/21

Doi : 10.1016/j.clinre.2020.101609

Marcos Bettini Pitombo ^a,^b, Claire Goumard ^a,^c,^d, Chetana Lim ^a, João Bernardo Sancio ^a, Alessandra Mazzola ^e, Frédéric Prat ^f, Jean-Christophe Vaillant ^g,^h, Filomena Conti ^e,^c,^d, Fabiano Perdigao ^a,⁎
^a APHP, Unité de Chirurgie Hépatobiliaire et Transplantation Hépatique, Hôpital Universitaire la Pitié Salpêtrière, Paris, France
^b Department of General Surgery, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
^c Sorbonne Université, INSERM, Institute of Cardiometabolisme and Nutrition (ICAN), Paris, France
^d Sorbonne Université, INSERM, Centre de recherche Saint-Antoine (CRSA), Paris, France
^e APHP, Unité Médicale de Transplantation Hépatique, Hôpital Universitaire la Pitié Salpêtrière, Paris, France
^f APHP, Service d’Endoscopie, Hôpital Beaujon, Clichy, France; Université de Paris, Paris, France
^g APHP, Service de Chirurgie Digestive, Hépato-Bilio-Pancreatique et Transplantation Hépatique, Hôpital Universitaire la Pitié Salpêtrière, Paris, France
^h Sorbonne Université, Paris, France

^⁎Corresponding author at: Unité de Chirurgie Hépatobiliaire et Transplantation Hépatique Hôpital Universitaire la Pitié Salpêtrière, Boulevard de l'Hôpital 47-83, 75013 Paris, France.Unité de Chirurgie Hépatobiliaire et Transplantation Hépatique Hôpital Universitaire la Pitié SalpêtrièreBoulevard de l'Hôpital 47-83Paris75013France

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Abstract

Background

De novo neoplasms are one of the major causes of death in patients after the first year of liver transplantation. The occurrence of sarcomas is extremely rare and the survival is often poor. However, early diagnosis and radical surgical treatment, may benefit some select liver transplant patients.

Method

We describe the case of a liver transplant patient who developed a locally advanced inferior vena cava (IVC) leiomyosarcoma, who underwent radical surgical treatment with resection of the IVC associated with duodenopancreatectomy, right nephrectomy, and IVC reconstruction. We address aspects of the diagnosis and surgical strategy.

Conclusion

This case report illustrates that IVC and multivisceral resections may be feasible and safe in highly selected liver transplant recipients. Major surgery should not be excluded as treatment option in an immunosuppressed liver transplant patient.

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Abbreviations : LT, IVC, DP, FNCLCC, TARPSWG, DFS, OS

Keywords : Liver transplantation, De novo malignancy, Vena cava leiomyosarcoma, Vena cava resection, Duodenopancreatectomy

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Introduction

Clinical case

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Authors contributions

Conflict of interest statement

Esportazione

Vol 45 - N° 6

Articolo 101609- Novembre 2021 Ritorno al numero

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Vena Cava and Pancreatic head En Bloc Resection for an Invasive Inferior Vena Cava Leiomyosarcoma in a Liver Transplant Patient - 11/11/21

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