Introduction
LMS, a subset of soft tissue sarcomas, refers to malignant smooth muscle
neoplasms accounting for about 5-10% of all sarcomas. Natural history
depends on the anatomic location where they arise. About 50% arise in
the retroperitoneum/abdomen, including the visceral, uterine, and
retroperitoneal, with the uterus being the most common location. Given
these tumors’ enormous size and frequent location, abdominal pain,
nausea, vomiting, anorexia, weight loss, fatigue, and malaise are their
most common symptoms. [1] Retroperitoneal sarcoma (RPS) is
relatively uncommon, accounting only for 10-15% of all soft tissue
sarcomas. [2] In a population-based series from the Surveillance,
Epidemiology, and End Results (SEER) database, the average annual
prevalence of RPS was approximately 2.7 cases per one million
population. [3] The LMS of the retroperitoneum arise from the
inferior vena cava, its tributaries, or any small vessel. When
diagnosed, they often emerge as a mass, usually in an enormous size.
Most knowledge in treating inferior vena cava (IVC) LMS comes from case
reports and case series. Surgical resection offers the best chance of
long-term survival and for the likelihood of cure. Remarkably, the
five-year disease-free survival rate of patients undergoing resection
was between 30and 60%; however, the survival in those who did not
undergo surgery was often below one year. [4-8] We aimed to share
our experience in encountering RPL with vascular and ureteral adhesion
in the operation room about a patient scheduled for surgery as a case of
leiomyoma.