Resection of inferior vena cava, abdominal aorta, bilateral common iliac arteries, and bilateral partial external iliac arteries with artificial vessel replacement during radical endometrial cancer surgery: a case report

Abstract

Background: Endometrial carcinoma (EC) is a common malignant tumor of the female reproductive system, often accompanied by lymph node metastasis. Artificial vascular implantation is a common surgical treatment for mediastinal tumors and abdominal aortic aneurysms but is rarely used in gynecological surgery.

Case presentation: A 54-year-old female patient was first admitted to the hospital in January 2018 due to "irregular vaginal bleeding over 3 months". CT showed a mass in the uterine cavity, and several swollen lymph nodes in the retroperitoneum and pelvic cavity. The initial diagnosis was an endometrial malignant tumor. We performed radical endometrial cancer surgery with parallel resection of inferior vena cava, abdominal aorta, bilateral common iliac arteries, bilateral external iliac arteries, and artificial vessel replacement, which was successful, with good postoperative recovery and no lesion progression at 3 years postoperative follow-up.

Conclusion: This is an early case of gynecological clinical use of prostheses. Through multidisciplinary cooperation, the surgical resection rate of patients with EC in radical surgery was improved without serious fatal complications and achieved a high long-term postoperative survival rate.

Keywords: Artificial vessel replacement; Endometrial cancer; Lymph node metastasis; Radical endometrial cancer surgery.

Fig. 1

Computed tomography (CT) of the endometrial. Multiple enlarged lymph nodes of varying sizes are seen in the retroperitoneum, adherent to and surrounding the retroperitoneal vessels

Fig. 2

Magnetic resonance imaging (MRI) of the endometrial. Multiple lymph nodes were enlarged retroperitoneally and adjacent to the right iliac vessels, which were adherent and wrapped around the vessels

Fig. 3

The tumor encloses blood vessels

Fig. 4

Intraoperative vascular replacement