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Case report
Leiomyosarcoma of the inferior vena cava posing as an adrenal incidentaloma
  1. Sinduja Ramanan1,
  2. Hemachandren Munuswamy2,
  3. Vishnu Prasad Nelamangala Ramakrishnaiah1 and
  4. Pampa Ch Toi3
  1. 1Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  2. 2Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  3. 3Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Sinduja Ramanan; dr.sindujaramanan20593{at}gmail.com

Abstract

Adrenal incidentalomas are incidentally detected adrenal lesions on imaging, which have a variety of differential diagnoses, the most common being a non-functioning adenoma. Surgical intervention for these lesions is needed when there is hypersecretion, for lesions larger than 4 cm and smaller lesions with suspicious characteristics. Here we present a young woman who was incidentally found to have a right suprarenal mass with loss of fat planes with the inferior vena cava (IVC). She underwent resection of the tumour along with the posterior wall of IVC, which was primarily repaired. Her postoperative biopsy was suggestive of leiomyosarcoma arising from the IVC. In the absence of distant metastasis, the sole prognostic factor for this tumour is achieving negative margins through radical resection of the tumour with IVC resection. Retroperitoneal leiomyosarcomas should be considered as a differential diagnosis for larger lesions, especially those more than 10 cm.

  • endocrine cancer
  • vascular surgery
  • radiology
  • pathology
  • surgical diagnostic tests

https://doi.org/10.1136/bcr-2020-238437

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    Footnotes

    • Contributors All the authors were equally involved in the preparation of this case report. VPNR was the primary operating surgeon and also revised the manuscript critically for intellectual content. SR contributed towards preparation of the case report. HM also operated on the patient and revised the manuscript critically for intellectual content. PCT gave the pathological diagnosis and revised the manuscript for its intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.