# Robotic resection of left renal vein with preservation of left kidney for leiomyosarcoma: Case report and review of the literature

## TL;DR

A 67-year-old woman with a rare kidney tumor underwent successful robotic surgery that preserved her kidney and had no complications or recurrence after 24 months.

## Contribution

This case report demonstrates the feasibility and safety of minimally invasive robotic resection for vascular leiomyosarcoma.

## Key findings

- Robotic resection of the left renal vein preserved the left kidney and achieved no tumor recurrence after 24 months.
- Minimally invasive surgery for vascular leiomyosarcoma is a feasible and safe option in selected cases.
- Preoperative histological diagnosis and radiological study enabled personalized treatment respecting oncological criteria.

## Abstract

Radical surgical resection with negative margins is the mainstay of treatment for retroperitoneal vascular leiomyosarcomas. Given the retroperitoneal location of these tumors, open surgery is, historically, the chosen surgical approach, however, it is burdened with high postoperative morbidity. In selected cases, the small dimension of the tumor and a favorable location, allow to perform a minimally invasive treatment.

A 67-year-old female patient with a diagnosis of a leiomyosarcoma arising from the left renal vein underwent a robotic resection of the left renal vein with preservation of the left kidney and a relative outflow trough the gonadal vessels. The patient was discharged on the fourth postoperative day without any complications and there was no tumor recurrence noted during the 24-month follow-up period.

Vascular retroperitoneal leiomyosarcomas are very rare tumors requiring a complete en bloc gross tumor resection in order to achieving microscopically negative margins on the vein of origin. Thanks to the preoperative histological diagnosis and radiological study of the neoplasm, it was possible to proceed to a highly personalized and minimally invasive treatment with respect of oncological criteria.

In selected cases, a minimally invasive surgery of vascular leiomyosarcoma could be a feasible and safe treatment option.

•Vascular leiomyosarcoma is a very rare soft tissue sarcoma.•Surgery with a complete primary resection and with negative margins is the gold standard treatment.•Open surgery is burdened with high postoperative morbidity.•In selected cases a minimally invasive surgery of vascular leiomyosarcoma could be pursued.

Vascular leiomyosarcoma is a very rare soft tissue sarcoma.

Surgery with a complete primary resection and with negative margins is the gold standard treatment.

Open surgery is burdened with high postoperative morbidity.

In selected cases a minimally invasive surgery of vascular leiomyosarcoma could be pursued.