Concomitant Reconstruction of Infrarenal Aorta and Inferior Vena Cava After En Bloc Resection of Retroperitoneal Rhabdomyosarcoma

Abstract

Adult paratesticular rhabdomyosarcoma (PRMS) with invasion of the retroperitoneum and involvement of the infrarenal aorta and inferior vena cava (IVC) is rare. We describe a 23-year-old male diagnosed with PRMS in 2008, previously treated with right orchiectomy, chemotherapy, and radiation, who presented with new onset of lower back pain. Computed tomography (CT) scan revealed a 4.8 × 4.2 cm mass involving both the infrarenal aorta and the IVC. We resected the tumor en bloc with in situ reconstruction of the aorta utilizing a Dacron graft and the IVC with a bovine pericardium roll graft. His postoperative period was uneventful, and he was discharged on postoperative day 6 in stable condition. At 2-month follow-up, the patient recovered well from the surgery, patent grafts on CT scan with no clinical signs of lower extremity ischemia or edema, and he continues to receive cycles of chemotherapy.

Keywords

paratesticular rhabdomyosarcoma infrarenal aorta and IVC concomitant reconstruction

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References

Haga

Kashiwagi

Nagamori

Yamashiro

(2005). Adult paratesticular rhabdomyosarcoma. Nat Clin Pract Urol, 2(8):398–402.

Bower

Nagorney

Cherry

Jr (2000). Replacement of the inferior vena cava for malignancy: an update. J Vasc Surg, 31(2):270–281.

Schneider

Sener

Barrera

Jr (2008). Combined replacement of infrarenal aorta and inferior vena cava after en bloc resection of retroperitoneal extraosseous osteosarcoma. J Vasc Surg, 48(2):478–479.

Song

Harris

Jr Raghavan

Norton

(2009). Major blood vessel reconstruction during sarcoma surgery. Arch Surg, 144(9):817–822.

Gow

Murphy

3rd Wu

Desa

(2003). Metastatic testicular rhabdomyosarcoma−a report of two cases. J Pediatr Surg, 38(8):E1–E3.

Ito

Watanabe

Harada

(1998). Combined resection of abdominal aorta and inferior vena cava for retroperitoneal rhabdomyosarcoma invading the aortoiliac bifurcation. J Pediatr Surg, 33(10):1566–1568.

Schwarzbach

Hormann

Hinz

(2005). Results of limb-sparing surgery with vascular replacement for soft tissue sarcoma in the lower extremity. J Vasc Surg, 42(1):88–97.

Baxter

Mahoney

Johnson

Selmer

Pipinos

Rose

(2007). Concomitant arterial and venous reconstruction with resection of lower extremity sarcomas. Ann Vasc Surg, 21(3):272–279.

Schwarzbach

Hormann

Hinz

(2006). Clinical results of surgery for retroperitoneal sarcoma with major blood vessels involvement. J Vasc Surg, 44(1):46–55.

10.

Kieffer

Bahnini

Koskas

(1991). Nonthrombotic disease of the inferior vena cava: surgical management of 24 patients. In Bergan

Yao

JST

(Eds.), Venous Disorders. Philadelphia, Pennsylvania: WB Saunders (pp. 501–516).

11.

Dzsinich

Gloviczki

Van Heerden

(1992). Primary venous leiomyosarcoma: a rare but lethal disease. In J Vasc Surg (pp. 15(4):595–603).

12.

Bower

Nagorney

Toomey

(1993). Vena cava replacement for malignant disease: is there a role?. Ann Vasc Surg, 7(1):51–62.

13.

Huguet

Ferri

Gavelli

(1995). Resection of the suprarenal inferior vena cava: the role of prosthetic replacement. Arch Surg, 130(7):793–797.

14.

Donaldson

Wirthlen

Donaldson

(1980). Thirty year experience with surgical interruption of the inferior vena cava for prevention of pulmonary embolism. Ann Surg, 191, 367–372.

15.

Agrifoglio

Edwards

(1961). Venous stasis after ligation of femoral or inferior vena cava. J Am Med Assoc, 178, 1–7.

16.

Collins

Burrus

DeBakey

(1960). Experimental evaluation of grafts in the canine inferior vena cava. Am J Surg, 99, 40–44.

17.

Reardon

Davies

(2009). Central venous stenosis−endovascular and surgical treatments. Methodist DeBakey Cardiovasc J, 5(4):32–35.

18.

Kim

Correa

Blackmon

(2011). Outcomes after right-side heart sarcoma resection. Ann Thorac Surg, 91(3):770–776.