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Japanese Journal of Clinical Oncology 2006 36(2):122; doi:10.1093/jjco/hyi237
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© 2006 Foundation for Promotion of Cancer Research

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A Case of Leiomyosarcoma Involving the Renal Hilus

Motokiyo Komiyama

Urology Division, National Cancer Center Hospital, Tokyo, Japan

A 50-year-old woman presenting with lumbago was referred to our institute in May 2005. Ultrasonography and dynamic computed tomography (CT) scan revealed a tumor, 4.5 cm in a diameter, involving the left renal hilus. The tumor was adjacent to the dorsal side of the abdominal aorta (Fig. 1, black arrow) and it extended into the inferior vena cava, forming a tumor thrombus filling a venous branch (Fig. 2, white arrow). Imaging studies showed that the tumor did not originate from the left kidney or the left adrenal gland. A CT-guided percutaneous biopsy was performed and the tumor was diagnosed as leiomyosarcoma.


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Aggressive surgical resection of the tumor involving left nephrectomy and tumor thrombectomy in the vena cava was performed successfully. The abdominal aorta was completely preserved. The tumor thrombus in the inferior vena cava filled a venous branch, possibly a lumbar vein. Histopathological examination of the resected specimen revealed leiomyosarcoma arising from a vessel wall. The growth pattern of this kind of leiomyosarcoma is rarely found.


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This Article
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