Leiomyosarkom der Vena cava inferior

Zusammenfassung

Anamnese und klinischer Befund: Wir berichten über eine 75-jährige Patientin, die sich mit Oberbauchschmerzen, Übelkeit und Erbrechen in unserer Klinik vorstellte.

Untersuchungen: Ursächlich war ein großer Tumor im rechten Retroperitoneum, dessen Organzuordnung durch Abdomensonographie und Computertomographie nicht zweifelsfrei gelang. Der endoskopische Ultraschall (EUS) und die endosonographische Feinnadelaspirationsbiopsie (EUS-FNA) ermöglichten die sichere immunhistologische Diagnose eines Leiomyosarkoms der Vena cava inferior (VCI).

Therapie und Verlauf: Die Behandlung bestand in der En-bloc-Resektion des tumortragenden Abschnitts der VCI und der Rekonstruktion durch ein Protheseninterponat.

Folgerungen: Diese Kasuistik unterstreicht das Potenzial von EUS und EUS-FNA für die Diagnostik von retroperitonealen Raumforderungen, in deren Differenzialdiagnostik das sehr seltene Leiomyosarkom der VCI Berücksichtigung finden sollte.

Summary

History and admission findings: A 75-year-old woman was admitted because of upper abdominal pain, nausea and vomiting.

Investigations: These symptoms were caused by a large tumor of the right retroperitoneal space. Computed tomography and transabdominal ultrasound did not unequivocally determine the site of the mass. Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration biopsy (EUS-FNA) ensured safe immunohistochemical diagnosis of a leiomyosarcoma of the inferior vena cava (IVC).

Treatment and course: The patient underwent successful en-bloc resection of the tumor and the IVC followed by prosthetic reconstruction.

Conclusions: This case emphasizes the role of EUS and EUS-FNA in the diagnosis of retroperitoneal lesions. Leiomyosarcoma of the IVC, although rare, should be considered in the differential diagnosis of a retroperitoneal mass.

Schlüsselwörter

endosonographische Feinnadelaspirationsbiopsie (EUS-FNA) - Endosonographie - Leiomyosarkom - Vena cava inferior - retroperitoneale Neoplasie

Key words

endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) - endoscopic ultrasound (EUS) - leiomyosarcoma - inferior vena cava - retroperitoneal neoplasm

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