Leiomyosarcoma of the inferior vena cava(IVC) is a rare tumor and has a poor prognosis. Recently, newer imaging modalities including ultrasound, computed tomographic scan, magnetic resonance imaging and cavovenography make it possible to detect in its early stage of proression. The best therapeutic management is surgical resection and the effects of postoperative adjuvant therapies on patients' survival are still debatable. We report herein our experience of 45-year-old woman whose leiomyosarcoma of the IVC was successfully resected without reconstruction of the IVC.
Female ; Humans ; Leiomyosarcoma* ; Magnetic Resonance Imaging ; Middle Aged ; Prognosis ; Ultrasonography ; Vena Cava, Inferior*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

The congenital absence of an inferior vena cava is an uncommon abnormality. With the advent of modern imaging techniques, such cases are being found with increasing frequency. Here we report a case of a renal cell carcinoma with the absence of an inferior vena cava in a 44 year-old male. He was referred for a further evaluation of a right renal mass, which was observed by ultrasonography, and for persistent epigastric discomfort. Computed tomography showed a huge mass in the right kidney and multicystic lesions in the left. In addition, the inferior vena cava had disappeared at the infrahepatic portion. He was treated with a right radical nephrectomy.
Adult ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Male ; Nephrectomy ; Ultrasonography ; Vena Cava, Inferior*

Forty five patients with inferior vena cava (IVC) thrombosis were studied with the use of ultrasonography (US) and computed tomography (CT). Thirty seven cases were cased by tumor extension and the primary neoplasms were hepatocellular Ca. (26cases), renal cell Ca. (6 cases), Wilms' tumor (1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the finkdings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and nontapered acute margin of thrombus made the possibility of tumor thrombus more likely.
Budd-Chiari Syndrome ; Diagnosis ; Humans ; Leiomyosarcoma ; Thrombophlebitis ; Thrombosis* ; Ultrasonography ; Vena Cava, Inferior* ; Wilms Tumor

Leimyosarcoma of the inferior vena cava is a rare disorder and may present with symptoms of obstruction of the normal flow of blood. We report a case of leiomyosarcoma of the inferior vena cava in 55-year-old female patient. The tumor was discovered incidentally by ultrasonography of the abdomen which was performed to evaluate epigastric pain and indigestion. Further radiological studies including CT and inferior vena cavography confirmed the presence of a 5cm sized mass in the inferior vena cava . The microscopic examination of a specimen obtained by a catheter from inferior vena cava mass revealed malignant mesenchymal tumor. The tumor was completely resected with reconstruction of the inferior vena cava and left renal vein. The diagnosis of leiomyosarcoma was made by micoscopic and immunohistochemical findings of the resected tumor.
Abdomen ; Catheters ; Diagnosis ; Dyspepsia ; Female ; Humans ; Leiomyosarcoma* ; Middle Aged ; Renal Veins ; Ultrasonography ; Vena Cava, Inferior*

In a 46 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven veno-venous bypass without cardiac arrest and cardiopulmonary bypass (CPB).
Biopsy, Needle ; Carcinoma, Renal Cell* ; Cardiopulmonary Bypass ; Dyspnea ; Heart Arrest ; Humans ; Kidney ; Melena ; Middle Aged ; Thrombosis ; Ultrasonography ; Vena Cava, Inferior*

PURPOSE: Venous thromboembolism (VTE) is a common life-threatening illness with significant morbidity and mortality rates. In recent years, the incidence of VTE has gradually increased in Korea. In this study, we evaluated the current trends in the management of acute deep vein thrombosis (DVT) in Korea. MATERIALS AND METHODS: A 20-item questionnaire was prepared and sent to 48 members of the Korean Society for Vascular Surgery. Each member worked in a different hospital. Twenty-two members participated in this study. RESULTS: The vascular surgery departments were primarily responsible for managing DVT. Ultrasound and computed tomography (CT) venography were chosen as the most common initial diagnostic tools. Eighty-two percent of participants routinely used the coagulation factor assay. Thrombolysis and inferior vena cava (IVC) filter insertion were performed mainly in the radiology departments. Seventy-seven percent of participants performed thrombolysis only if the thrombus age was less than 21 days. During thrombolysis, IVC filter was routinely inserted by 50% of respondents and removed within 14 days by 64% of respondents. Nearly all participants followed the 2012 American College of Chest Physicians guidelines for anticoagulation therapy. CONCLUSION: The majority of Korean vascular surgeons followed the guidelines. However, CT was frequently used. Thrombolysis and IVC filter insertion were more frequently performed than recommended by the guidelines.
Blood Coagulation Factors ; Surveys and Questionnaires ; Incidence ; Korea ; Mortality ; Phlebography ; Thorax ; Thrombosis ; Ultrasonography ; Veins ; Vena Cava, Inferior ; Venous Thromboembolism ; Venous Thrombosis*

PURPOSE: For evaluation of volume status in the emergency department, central venous pressure (CVP) measurement is a standard practice. However, this is an invasive method. Measuring inferior vena cava (IVC) size through ultrasound is promising as a non-invasive method. However, few studies have been reported in Korea. Therefore this study measured IVC size and collapsibility in order to examine the clinical usefulness. METHODS: In a prospective study setting, IVC size was measured with ultrasound for patients whose CVP was measured in the emergency department. IVC size of healthy applicants was measured. RESULTS: The healthy group included 100 people: 68 men and 32 women. The average IVC size of men was 1.8+/-0.4 cm and that of women was 1.8+/-0.3 cm. For collapsibility, men were 0.28+/-0.14 and women were 0.23+/-0.14, thus there was no statistical difference in size and collapsibility between men and women. The patient group included 51 people, average age was 59.9+/-18.5, and 28 (54.9%) were men. This group showed a significant negative correlation between CVP and collapsibility. IVC Max was 1.7+/-0.5 cm, IVC Min was 1.2+/-0.5 cm, median collapsibility was 0.26 (0.15-0.38), mean lactate was 6.4+/-4.4 mmol/L, and median CVP was 10.0 (1.0-14.5) cmH2O. CONCLUSION: IVC collapsibility can be used as a reference measure, or even instead of CVP in certain cases.
Central Venous Pressure* ; Emergency Service, Hospital ; Female ; Humans ; Korea ; Lactic Acid ; Male ; Prospective Studies ; Ultrasonography ; Vena Cava, Inferior*

PURPOSE: There have been several studies addressing the correlation between central venous pressure (CVP) and ultrasonographic findings of the inferior vena cava (IVC). We performed the present study to discover the degree of correlation between CVP and the area of IVC as measured with ultrasound, and to determine which portion of the IVC shows the best correlation with CVP. METHODS: The present study was prospectively performed in emergency medical center of Chonnam National University Hospital from March 1 to October 31, 2006. Two intrahepatic portions and one extrahepatic portion of the IVC were evaluated. RESULTS: All tested areas of the IVC, and the collapsibility indices measured at each location, showed a substantial correlation with CVP. However, in multiple logistic regression analysis performed to identify the location best correlated with CVP, the area of the IVC just below the hepatic vein-IVC junction proved to be the only location to correlate with CVP with statistic significance. CONCLUSION: Measurement of IVC area using ultrasound can yield important information about a patient's volume status, especially in patients for whom central venous catheter insertion is contraindicated. We suggest that the portion of the IVC just below the hepatic vein-IVC junction is the optimal locatin for area measurement to estimate CVP.
Central Venous Catheters ; Central Venous Pressure* ; Emergencies ; Humans ; Jeollanam-do ; Logistic Models ; Prospective Studies ; Ultrasonography* ; Vena Cava, Inferior*