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Case Reports
. 2021 Dec 23;8(1):70-74.
doi: 10.1016/j.jvscit.2021.11.008. eCollection 2022 Mar.

Complete resection and arterial reconstruction for primary sarcoma arising from superior mesenteric artery

Shota Hasegawa  1 , Yoshikatsu Nomura  1 , Takuya Okada  2 , Hirochika Toyama  3 , Takumi Fukumoto  3 , Kenji Okada  1
Affiliations
Case Reports

Complete resection and arterial reconstruction for primary sarcoma arising from superior mesenteric artery

Shota Hasegawa et al. J Vasc Surg Cases Innov Tech. .

Abstract

In the treatment of retroperitoneal sarcoma involving major vessels, complete resection with vascular reconstruction is challenging. We describe the case of a 72-year-old man who presented with 8 months of abdominal pain. Diagnostic workup revealed occlusion of the celiac trunk and the origin of the superior mesenteric artery due to a soft tissue sarcoma. Radical resection of the tumor and vessels was performed. Guided by intraoperative angiography, arterial reconstruction was performed without mesenteric ischemia. All arterial margins were negative. At the 6-year follow-up, the patient was alive with no evidence of recurrence.

Keywords: Arterial reconstruction; Complete resection; Pleomorphic sarcoma.

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Figures

Fig 1
Fig 1
Preoperative computed tomography images. The red arrows indicate a round mass centered into the superior mesenteric artery (SMA). A, Axial image demonstrating a mass centered within an SMA with wall enhancement. B, Coronal image demonstrating a partial filling defect in the distal SMA. C, Three-dimensional computed tomography angiography (CTA). The SMA was occluded to the range indicated by a yellow arrow. D,18F- fluorodeoxyglucose (FDG) positron emission tomography/computed tomography on coronal images. FDG uptake (a maximal standardized uptake value = 28.5) was shown, suggestive of a malignant lesion.
Fig 2
Fig 2
A, Illustration of a tumor and visceral perfusion. B, Illustration of final arterial reconstruction. CHA, Common hepatic artery; CT, celiac trunk; IMA, inferior mesenteric artery; SMA, superior mesenteric artery.
Fig 3
Fig 3
A, Hematoxylin and eosin staining of the tumor. The tumor was composed of spindle-shaped cells arranged in fascicles. B, Resected sarcoma tissue. The origin of a superior mesenteric artery (SMA) was marked with red ink.
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