CASE 242: IVC TUMOR, Dr PHAN THANH HẢI, Dr LÝ VĂN PHÁI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman 35 yo, pain at epigastric area. Ultrasound in a provencial hospital suspected liver tumor, and  reviewing of ultrasound at MEDIC center.

This mass was hypoechoic structure with  size of 7cm X 5cm along of upper portion of IVC in covering over right kidney and duodenum (see 4 ultrasound pictures). 

MSCT with CE of  this mass was slow enhancement, and in invasion of the wall of IVC ( see 3 CT pictures).

Gastroendoscopy was ruling out a tumor from duodenum.

Blood test : CA19-9 rising of  62.58 UI/mL

What is your suggestion of diagnosis and planning for treatment ?.

Discussion: this case did not have GI tract  symptoms , no endocrinal effect, and the mass  situated  in retroperitoneum  and  IVC compression, we can rule out  liver tumor, GIST of duodenum, kidney tumor. The rest of retroperitoneal tumors  near I V C are  neuroendocrine tumor  or leiomyosarcoma, liposarcoma with CA 19-9 rising, we cannot explain  what is  situation. Pre-op  diagnosis is retro peritoneum tumor looked like sarcoma. Operation was done for removing completely  this mass  with one part of IVC (see 2 operation samples). Microscopy report was a retroperitoneal leiomyosarcoma.

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